Anyone willing to share their coding knowledge on coding this????
DESCRIPTION OF PROCEDURE: With the patient supine on the operating table
in the radiology suite and under general anesthesia both femoral/inguinal
areas were prepped and draped in a sterile fashion. A longitudinal
incision was made first over the right common femoral artery. Dissection
was carried down to subcutaneous tissue and hemostasis was achieved with
electrocautery. Dissection was carried down to the common femoral artery.
The common artery, superficial femoral artery, profunda femoris arteries
were carefully surrounded by Vesseloops. Once this had been performed,
attention was then turned to the patient's left groin. An identical
mirror image incision was made and dissection was carried out. Once this
had been completed exposure of both vessels were obtained. At this point
we then proceeded with endovascular aortic repair using co-surgeon
technique with both Dr. Maxwell and Dr. Baker performing the procedure.
This portion has also been dictated by Dr. Baker separately. Following
successful placement of the endovascular graft, the left sheath was
carefully removed. Following removal of this sheath, the left common
femoral artery was closed with a running suture of 6-0 Prolene. Attention
was then turned to the right leg. Clamps were again placed on the vessel
in the right groin; however, following removal of the sheath on the right
side there was significant atherosclerotic disease at the site of puncture
and closure of the artery would have caused significant stenosis of this
area. We, therefore, opened the artery further laterally and medially and
performed a careful endarterectomy of the common femoral artery. Care was
taken following endarterectomy to make sure all the small medial fragments
were removed. Once this was performed, the area was thoroughly irrigated
with heparinized saline. Distally blood flow was back bled. Once it was
established that an adequate endarterectomy had been completed, the
arteriotomy was closed with a running suture of 6-0 Prolene. Both groins
were then closed with 2-0 Vicryl for the
deep layer, 3-0 Vicryl for the superficial layer, and interrupted vertical
mattress sutures of 4-0 nylon for the skin. The patient tolerated the
procedure well.
DESCRIPTION OF PROCEDURE: With the patient supine on the operating table
in the radiology suite and under general anesthesia both femoral/inguinal
areas were prepped and draped in a sterile fashion. A longitudinal
incision was made first over the right common femoral artery. Dissection
was carried down to subcutaneous tissue and hemostasis was achieved with
electrocautery. Dissection was carried down to the common femoral artery.
The common artery, superficial femoral artery, profunda femoris arteries
were carefully surrounded by Vesseloops. Once this had been performed,
attention was then turned to the patient's left groin. An identical
mirror image incision was made and dissection was carried out. Once this
had been completed exposure of both vessels were obtained. At this point
we then proceeded with endovascular aortic repair using co-surgeon
technique with both Dr. Maxwell and Dr. Baker performing the procedure.
This portion has also been dictated by Dr. Baker separately. Following
successful placement of the endovascular graft, the left sheath was
carefully removed. Following removal of this sheath, the left common
femoral artery was closed with a running suture of 6-0 Prolene. Attention
was then turned to the right leg. Clamps were again placed on the vessel
in the right groin; however, following removal of the sheath on the right
side there was significant atherosclerotic disease at the site of puncture
and closure of the artery would have caused significant stenosis of this
area. We, therefore, opened the artery further laterally and medially and
performed a careful endarterectomy of the common femoral artery. Care was
taken following endarterectomy to make sure all the small medial fragments
were removed. Once this was performed, the area was thoroughly irrigated
with heparinized saline. Distally blood flow was back bled. Once it was
established that an adequate endarterectomy had been completed, the
arteriotomy was closed with a running suture of 6-0 Prolene. Both groins
were then closed with 2-0 Vicryl for the
deep layer, 3-0 Vicryl for the superficial layer, and interrupted vertical
mattress sutures of 4-0 nylon for the skin. The patient tolerated the
procedure well.