Procedure: Emergency salvage triple bypass with reverse saphenous vein to the obtuse marginal, right posterior descending and left internal mammary artery bypass to the anterior descending.
Details of Procedure: The patient was brought emergently to the operating room, prepped and draped. Incision was made. The left internal mammary artery was harvested while vein harvested form ultimately the right leg. The patient had extensive varicosities in both legs. Adequate conduit was obtained for bypass. The internal mammary was good size with good flow to it when transected. The vein had multiple varicosities. The ascending aorta was thick but non-calcified. The heart was arrested. Distal anastomosis was fashioned to the obtuse marginal, the diffusely diseased artery that would allow 1-1/2 probe, to the right posterior descending also diffusely diseased which would allow a 1-1/2 probe to passed retrograde and 1 mm probe to passed ante grade. The internal mammary was then anastomosed to the LAD and the middle circ. This artery was extensively diseased from his origin all the way to the apex of the heart. A soft spot was found fortunately in the mid portion which could be opened and from this point a 1-1/2 probe could be passed retrograde for some distance back to the base of the heart and a 1 mm probe could be passed distally beyond an obstruction noted on the cardiac catheterization, but a 1 probe could be easily passed beyond this into distal LAD as the apex. The clamp was removed after a total clamp time of 93 minutes. Pacing wires were applied. The patient reverted spontaneously to sinus rhythm without defibrillation and was weaned form cardiopulmonary bypass on minimal support. Total bypass time was 114 minutes. Of note patient had been on Eliquis right up to the time surgery so bleeding was extensive requiring multiple blood products. After a period of observation, the chest was closed in the usual fashion after copious and repeated antibiotic irrigation to the Intensive Care Unit.
I am new in cabg procedure coding. The following codes are my findings:
-33533
-33518
?
My auditor say's there was no vein to be coded(33518) since not mentioned in details that was really done and it must be 33534 for a 2 artery harvest instead of (33533). And I feel like there was something that make me so confused.
Please any output will be appreciated.
Thanks...
Details of Procedure: The patient was brought emergently to the operating room, prepped and draped. Incision was made. The left internal mammary artery was harvested while vein harvested form ultimately the right leg. The patient had extensive varicosities in both legs. Adequate conduit was obtained for bypass. The internal mammary was good size with good flow to it when transected. The vein had multiple varicosities. The ascending aorta was thick but non-calcified. The heart was arrested. Distal anastomosis was fashioned to the obtuse marginal, the diffusely diseased artery that would allow 1-1/2 probe, to the right posterior descending also diffusely diseased which would allow a 1-1/2 probe to passed retrograde and 1 mm probe to passed ante grade. The internal mammary was then anastomosed to the LAD and the middle circ. This artery was extensively diseased from his origin all the way to the apex of the heart. A soft spot was found fortunately in the mid portion which could be opened and from this point a 1-1/2 probe could be passed retrograde for some distance back to the base of the heart and a 1 mm probe could be passed distally beyond an obstruction noted on the cardiac catheterization, but a 1 probe could be easily passed beyond this into distal LAD as the apex. The clamp was removed after a total clamp time of 93 minutes. Pacing wires were applied. The patient reverted spontaneously to sinus rhythm without defibrillation and was weaned form cardiopulmonary bypass on minimal support. Total bypass time was 114 minutes. Of note patient had been on Eliquis right up to the time surgery so bleeding was extensive requiring multiple blood products. After a period of observation, the chest was closed in the usual fashion after copious and repeated antibiotic irrigation to the Intensive Care Unit.
I am new in cabg procedure coding. The following codes are my findings:
-33533
-33518
?
My auditor say's there was no vein to be coded(33518) since not mentioned in details that was really done and it must be 33534 for a 2 artery harvest instead of (33533). And I feel like there was something that make me so confused.Please any output will be appreciated.
Thanks...
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