# Help with Procedure code PLEASE!!!!!!



## Coastal Coder (Apr 6, 2016)

Below is a procedure note that I have searched for any CPT code I could use and can't find anything that fits this procedure. Any HELP would be greatly appreciated. 

Thanks for any help!




DESCRIPTION OF PROCEDURE:
He was brought into the operating room suite. He was placed in the supine position  where he was placed
under general anesthesia without any complications. He was then rolled into the jack-knife prone position. His buttocks were taped to the side, and he was prepped and draped in the usual sterile fashion.   It was clearly visible but there was one arterial bleeder that was located in the wound bed. It was actually on the buttocks just outside of the anus and not actually inside of the anus. I used a 3-0 catgut and placed a figure-of-eight  suture deep into the tissues around this bleeder, and then used electrocautery as well.  There were some other areas that were oozing slightly, and these were controlled with electrocautery, but this initial arterial bleeder clearly was the source of his excessive blood loss. I inspected the entire fistula tract.   I inserted a retractor into the
anus to make sure that there was nothing bleeding from higher up, there clearly was not. The rest of the wound
bed appeared to be dry. I  irrigated with normal saline.   I infiltrated the entire area with Marcaine combined with epinephrine. I then packed the wound with Surgicel and then 4x4s and fluff gauze and ABO.  The patient was awoken from anesthesia and transferred to the recovery room in stable condition.  Needle, sponge, and instrument counts were all correct at the end of the case. The patient tolerated the procedure well.  He will
likely be discharged from the recovery room today.  Needle, sponge, and instrument counts were all correct at the end of the case.


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## SienTC1720 (Apr 6, 2016)

The only thing I could think of for this wound be wound closure. Although you would need the size of the wound, or just bill the smallest (13131). Hope that helps!


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## jjhamer1 (Apr 11, 2016)

Look at 37617 - Ligation, major artery; abdomen

Abdominal arteries listed below:
abdominal arteries; aorta; appendicular artery; celiac trunk; colic artery; cystic artery; epigastric artery; epiploics artery; femoral artery; femoral circumflex artery; gastric artery; gastroduodenal artery; gastro-omental artery; gluteal artery; hepatic artery; ileal arteries; ileocolic artery; iliac artery; iliac circumflex artery; iliolumbar artery; jejunal arteries; lumbar artery; mesenteric artery; obturator artery; ovarian artery; pancreaticoduodenal artery; pelvic arteries; penis arteries; phrenic artery; portal vein; pudendal artery; rectal artery; renal artery; renal vein; sacral artery; sigmoid artery; splenic artery; supraduodenal artery; suprarenal artery; testicular artery; umbilical artery; vena cava; vesical artery


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## cynthiabrown (Apr 11, 2016)

*anal fistula*

46270


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