# CABG Lima to Lad



## Melonyw (Apr 30, 2009)

Will someone please help me code a operative report please  I am trying to learn and teach myself in Cardio Coding not having much luck;( 


Its a off-pump Lima to Lad.

The internal mammary artery was dissected free from the chest wall. Upon completion, the patient was heparinized. The off-pump sternal retractor placed and the mammary pedicle was ligated. There had been no entrance into the left pleural space and a small tunnel was made into the pericardium. Three pericardial stitches were placed on the left side and a lap pad was placed behind the heart. The LAD was identified and a stabilization footplate was brought up and into position. A proximal occluding stitch was placed and the LAD was occluded. Arteriotomy was performed. A 1.75-mm shunt was attempted to be placed and did not fit proximally but did fit distally. The mammary pedicle was brought up and end-to-side anastomosis was performed with 8-0 prolene in a runnning fashion using the parachute technique. Upon completion, the shunt was removed. The bulldog was removed from the mammary pedicle. The pedicle was attached in place with 5-0 prolene. The pericardium was loosely reapproximated with running vicryl. A blake drain was placed and the sternum was reapproximated with figure-of-eight sternal wires followed by closure of the rectus and pectoralis fascia, subdermal and subcuticular closure with dermabond for the skin.

I don't even know where to begin this is so frustrating 

Does anyone what are some good sites where I can learn more about cardio coding please!!


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## dpumford (May 1, 2009)

There is no code for off pump bypass at this time.  Since only the mammary was used you would just code 33533.


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