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Thread: PLEASE HELP Aortic dissection with acute limb ischemia

  1. #1
    Join Date
    Apr 2007
    Greeley, Colorado

    Question PLEASE HELP Aortic dissection with acute limb ischemia

    AAPC: Back to School
    I have an extremely complicated procedure that I need help on... I will start by listing just the "operation" (and not the entire note) to see what else anyone/everyone needs to guide me (please!!).
    1. Open exposure of the left common femoral artery with femoral artery repair and patch angioplasty
    2. Catheter placement in aorta through femoral arteries bilaterally with percutaneous technique on the right side
    3. Balloon angioplasty and stent of the iliac artery dissection with a left common iliac artery fenestration procedure

    I am still quite green when it comes to vascular surgery, so along with help with coding, I have a question about fenestration. If I understand this term in this context, it means that the dissection caused a closure that the surgeon had to re-open?

    Lisa Bledsoe, CPC, CPMA

  2. #2
    Join Date
    Apr 2007
    New Delhi, India


    Yes, by fenestration he means opening the lumen that might have been compromised due to dissection. Please check following set of codes:

    37221 - Iliac fenestration procedure plus stenting.

    37224-51 - Femoral artery repair plus patch angioplasty.

    Aortic catheterization is included in both of these codes. It's always good to post a scrubbed OP report.

    Hope this helps.
    Girish Dadhich, CPC

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    Thank you SOOOO much!!
    Lisa Bledsoe, CPC, CPMA

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