Wiki Axillary Graft for Bypass During Arch Grafting

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fhromeo30

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Hello,

If a graft is placed in the axillary vein to use for CardioPulmonary bypass during a total arch replacement--do we code the creation of the axillary graft? I'm thinking it is included in the primary procedure which requires bypass but I would like confirmation.

After informed consent was obtained, the patient was taken to the operating room. Lines and monitors were placed by anesthesia. Central line, bilateral radial arterial lines were placed. The patient tolerated general endotracheal anesthesia. Transesophageal echo was inserted. The patient was then prepped and draped in the usual sterile fashion. A left femoral A-line was placed to have additional arterial monitoring. Next, a right infraclavicular incision was made down to the axillary artery. Axillary artery was dissected and proximal/distal control obtained. 5,000 units of heparin was given. An 8 mm Hemashield graft was then sewn end-to-side to the axillary artery and set aside. Median sternotomy was made. Pericardium was opened and well was established. The ascending aorta was very large and bluish in color, indicating a near rupture. The upper mediastinum was dissected. Systemic heparin was given. Arterial line of the heart-lung machine was connected to the Hemashield graft. Venous cannula was placed in the right atrial appendage directed into the IVC. The patient was then placed on cardiopulmonary bypass.

Francine Cahoon
 
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Thank you. Is all work associated with connecting the patient to bypass billable? (My CCVTC coder is out of office and I'm struggling with what to bill in relation to bypass)
 
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