Wiki Brachial Artery Cutdown and repair..help!!

[espada]

Hello all,

My surgical group recently merged with a group that also has vascular surgeons, and I'm just learning the world of vascular coding. I need help with a code for a brachial artery cutdown and repair, please see the procedure note below:

"Procedure: The patient was prepped and draped. A transverse incision was made in the left arm just above the antecubital fossa. Dissection was carried down to the brachial artery. There was no palpable pulse in the brachial artery. It was freed of attachments and encircled proximally and distally. Procedure was then turned over to Dr. XXX for an attempt at subclavian angioplasty and stend. Following the procedure there was an opening in the brachial artery requiring closure. This was closed with interrupted 7-0 Prolene sutures. The artery was flushed proximally and distally and secured. Hemostasis was adequate. Surgicel was placed over the artery. The wound was irrigated with saline and closed in layers with 3-0 Vicryl and 4-0 nylon. "

Just a nudge in the right direction would be helpful

 

[jewlz0879]

Hmmm I'm not 100% sure there is a code for the bracial artery cutdown of this nature; 34834 is for brachial artery cutdown for the deployment of the an aortic or iliac endovascular graft. It seems to me this would be the opening for the procedure and in my experience you don't always get to bill separately for that. He went in thru the brachial artery and closed it.

For the closure - you can take a look at 35206 but again that code is for repair of an injured blood vessel. Usually, you can't bill for clousure because it is included with the procedure. You might be able to in your case.

Sorry that wasn't more helpful. You could always go and speak with your physician to see what his thoughts are and to have a better understanding what he did.

 

[mm.rogers@comcast.net]

While I realize this is several years since the initial post, 37207 w/75960 (prn) would be my first choice, not including any ancillary diagnostic studies that may have been performed.