Results 1 to 3 of 3

Evar

  1. #1
    Default Evar
    Medical Coding Books
    Anyone willing to share their coding knowledge on coding this????



    DESCRIPTION OF PROCEDURE: With the patient supine on the operating table
    in the radiology suite and under general anesthesia both femoral/inguinal
    areas were prepped and draped in a sterile fashion. A longitudinal
    incision was made first over the right common femoral artery. Dissection
    was carried down to subcutaneous tissue and hemostasis was achieved with
    electrocautery. Dissection was carried down to the common femoral artery.
    The common artery, superficial femoral artery, profunda femoris arteries
    were carefully surrounded by Vesseloops. Once this had been performed,
    attention was then turned to the patient's left groin. An identical
    mirror image incision was made and dissection was carried out. Once this
    had been completed exposure of both vessels were obtained. At this point
    we then proceeded with endovascular aortic repair using co-surgeon
    technique with both Dr. Maxwell and Dr. Baker performing the procedure.
    This portion has also been dictated by Dr. Baker separately. Following
    successful placement of the endovascular graft, the left sheath was
    carefully removed. Following removal of this sheath, the left common
    femoral artery was closed with a running suture of 6-0 Prolene. Attention
    was then turned to the right leg. Clamps were again placed on the vessel
    in the right groin; however, following removal of the sheath on the right
    side there was significant atherosclerotic disease at the site of puncture
    and closure of the artery would have caused significant stenosis of this
    area. We, therefore, opened the artery further laterally and medially and
    performed a careful endarterectomy of the common femoral artery. Care was
    taken following endarterectomy to make sure all the small medial fragments
    were removed. Once this was performed, the area was thoroughly irrigated
    with heparinized saline. Distally blood flow was back bled. Once it was
    established that an adequate endarterectomy had been completed, the
    arteriotomy was closed with a running suture of 6-0 Prolene. Both groins
    were then closed with 2-0 Vicryl for the

    deep layer, 3-0 Vicryl for the superficial layer, and interrupted vertical
    mattress sutures of 4-0 nylon for the skin. The patient tolerated the
    procedure well.

  2. #2
    Location
    Richardson, TX
    Posts
    822
    Default
    Quote Originally Posted by berger View Post
    Anyone willing to share their coding knowledge on coding this????



    DESCRIPTION OF PROCEDURE: With the patient supine on the operating table
    in the radiology suite and under general anesthesia both femoral/inguinal
    areas were prepped and draped in a sterile fashion. A longitudinal
    incision was made first over the right common femoral artery. Dissection
    was carried down to subcutaneous tissue and hemostasis was achieved with
    electrocautery. Dissection was carried down to the common femoral artery.
    The common artery, superficial femoral artery, profunda femoris arteries
    were carefully surrounded by Vesseloops. Once this had been performed,
    attention was then turned to the patient's left groin. An identical
    mirror image incision was made and dissection was carried out. Once this
    had been completed exposure of both vessels were obtained. At this point
    we then proceeded with endovascular aortic repair using co-surgeon
    technique with both Dr. Maxwell and Dr. Baker performing the procedure.
    This portion has also been dictated by Dr. Baker separately. Following
    successful placement of the endovascular graft, the left sheath was
    carefully removed. Following removal of this sheath, the left common
    femoral artery was closed with a running suture of 6-0 Prolene. Attention
    was then turned to the right leg. Clamps were again placed on the vessel
    in the right groin; however, following removal of the sheath on the right
    side there was significant atherosclerotic disease at the site of puncture
    and closure of the artery would have caused significant stenosis of this
    area. We, therefore, opened the artery further laterally and medially and
    performed a careful endarterectomy of the common femoral artery. Care was
    taken following endarterectomy to make sure all the small medial fragments
    were removed. Once this was performed, the area was thoroughly irrigated
    with heparinized saline. Distally blood flow was back bled. Once it was
    established that an adequate endarterectomy had been completed, the
    arteriotomy was closed with a running suture of 6-0 Prolene. Both groins
    were then closed with 2-0 Vicryl for the

    deep layer, 3-0 Vicryl for the superficial layer, and interrupted vertical
    mattress sutures of 4-0 nylon for the skin. The patient tolerated the
    procedure well.
    I see:
    34812 - 50 (Open femoral artery exposure)
    35371 - 59 Endarterectomy Common Femoral

    You still need the to get the co-surgeon's report. For the graft it will be from codes 34802-34804 (these are most common) but i can't tell you what code because this report does not specify what kind of graft. I.E. Cook Zenith, Treovance, Powerlink, Aneurx, Excluder...you get the point. S&I for Endo graft 75952.

    Once you get the other report, if there were extensions done, take a look at 34825/34826 S&I 75953.

    You can also bill for cath placement in aorta, if documented 36200 LT/RT OR 36200-50. I also don't see any mention of cath placement within this report; could be that the other physician did that portion.

    IVUS, if performed 37250/75945. But it doesn't look like your physician did any of that.

    These can be tricky at first but once you get them they are easy peasy. I have a cheat sheet that is very helpful. Here is my email if you have any questions. julie.graham4@hcahealthcare.com
    Julie Graham, BA, CPC, CCC

  3. #3
    Default
    Thanks so much!!

Similar Threads

  1. Help with Repair of EVAR Endoleak and Rt IIAneurysm
    By SPECIALTYCODING in forum Interventional Radiology
    Replies: 0
    Last Post: 05-13-2015, 12:38 PM
  2. Evar abdominal aortic aneurysm repair
    By sslater in forum Cardiovascular Thoracic
    Replies: 3
    Last Post: 11-10-2014, 12:46 PM
  3. EVAR AAA Repair with Stent Graft
    By sslater in forum General Surgery
    Replies: 0
    Last Post: 10-29-2014, 08:14 AM
  4. Evar
    By carolhpolk in forum Cardiovascular Thoracic
    Replies: 1
    Last Post: 05-07-2013, 06:10 AM
  5. femoral cutdown without EVAR
    By kimcpccircc in forum Interventional Radiology
    Replies: 1
    Last Post: 06-25-2012, 09:14 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.