# femoral cutdown without EVAR



## kimcpccircc (Jun 21, 2012)

Would love some opinions on this:

right femoral artery cutdown, open sheath placement with angio revealing patent SFA with an occlusion at Hunter's canal, apprximately 10 cm. Then attempted glidewire, mini wire etc.....was unable to pass through occlusion. Completion angio shows no dissection.

at this point, the arteriotomy was repaired with prolene, sheath removed, and the wound was closed in layers and reapproximated the skin with clips.

I am coming up with direct repair of artery?? 35226


----------



## dpumford (Jun 25, 2012)

Hello:

Procedure code 35226 is typically used for repair of an injured blood vessel...Which in this senario does not seem to be what happend...This was a cut down, not a injury.

Was the attent of this procedure to be a endo graft placement for a AAA?  If so I believe using 34812-Rt would be appropriate..This does include the repair...And I would used dx 441.4 if it was a AAA.

You should also code for the catheter placement  if a catheter was able to be placed.  The wire does not count for the catheter placement..Also you can bill for the angio 75710-26.  

With out the full report I can't be sure but this should help to get you in the right direction, I hope


----------

