The correct CPT code for split-thickness autograft is determined by anatomic site and body surface area of the recipient.     15100 would be coded for the application of a graft to the trunk, arms, legs; affecting 100 sq cm or less body area in a patient older than 10 years of age,     15120 would be applicable for split-thickness graft to the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; covering 100 sq cm or less in patient 10 years or older.     If properly documented by the physician, a code may be reported in addition to the skin graft code describing surgical preparation of the recipient wound site, 15002 or 15004 depending on the anatomic site, or possibly a wound debridement code ranging 11000 - 11047 depending on the type of wound and depth of tissue removed.

Please advise with coding. Thanks in advance (I know its a long op report)!!! I know I can code 35371 for the femoral thrombroendarterectomy, but I am unsure of angioplasties. PREOPERATIVE DIAGNOSIS: Bilateral lower extremity claudication and rest pain in left lower extremity. POSTOPERATIVE DIAGNOSIS: Bilateral lower extremity claudication and rest pain in left lower extremity.

What is the CPT code for thromboendarterectomy with patch graft of iliac artery? Already exists. Would you like to merge this question into it?

OPERATION PERFORMED: 1. Bilateral common femoral thromboendarterectomy with Dacron patch angioplasty. Retrograde aortoiliac angiogram. Download Ebook Semiotika Komunikasi Alex Sobur Software. Bilateral lower extremity runoff. Percutaneous transluminal angioplasty of left common and external iliac, 6 x 4 balloon. Percutaneous transluminal angioplasty of right common iliac and external iliac, 5 x 4 and 6 x 4 balloons. INDICATIONS FOR OPERATION: This is a 61-year-old male with a diffuse history of atherosclerotic disease, multiple prior revascularizations including a prior right femoral-to-popliteal artery bypass graft, who has had progressive worsening of his claudication, deterioration of his ABIs and now has an ABI of 0.3 on the left with rest pain and claudication in the left leg and claudication on the right.

DESCRIPTION OF OPERATION: With the patient in the supine position under general anesthesia, time-out protocols were observed. Monitoring lines were placed by Anesthesia and a Foley catheter by the OR staff. He was prepped and draped appropriately. Time- out protocols were observed.

Intravenous antibiotics were administered. With the supplementation with additional local Marcaine, the left groin was opened obliquely. The common, superficial and profunda femoris arteries were dissected out, found to be extremely hard and calcified and with palpable near total obliteration of the common femoral artery on the left side extending up into the external iliac. The inguinal ligament was mobilized and retracted, and the external iliac was mobilized to a distance of about 5-6 cm until an area of a softer and clampable vessel was obtained. The patient was fully heparinized.

The femoral bifurcation vessels were clamped. The external iliac was clamped and an opening was made in the common femoral artery, extended up onto the proximal external iliac into a point where there was a significant residual lumen of the external iliac. Microsoft Research Autocollage Touch 2009. The common femoral had no significant residual lumen, although there was some lumen. Endarterectomy was then performed, carried down to the femoral bifurcation where the plaque was transected and the orifice of the profunda and SFA were tacked down. A Hemashield Dacron patch was sutured on as on onlay patch using a running 5-0 Prolene suture with standard techniques. Prior to completion of closure, flushing maneuvers were performed.

Closure was completed. Clamps were removed, and improved although not excellent flow was noted in the common femoral artery. This was now pulsatile and had better Doppler characteristics than had been present performed.

The artery was then accessed through the patch using a micropuncture needle, wire and sheath under fluoroscopic direction with the sheath placed up into the external iliac artery. Retrograde angiography showed significant diffuse disease involving the external, iliac and common iliac arteries. An 0.035 wire was passed into the abdominal aorta. An angiogram was done that actually showed the distal aorta and some spillover into the right side, which also was heavily diseased.

The sheath was upsized to a standard 5-French sheath and then a 6 x 4 balloon was passed into the abdominal aorta and then withdrawn into the iliac origin, and sequential handheld injections of the iliac throughout its length were performed all the way back down to the level of the endarterectomy of the femoral artery. When this was complete, there was an excellent pulse in the groin not present previously, and retrograde angiography showed diffuse improvement of the whole iliac system. The balloon was removed. The sheath was removed and a Prolene suture was used to control bleeding from the patch. Several additional sutures were required with the increased pressure head to complete hemostasis, and at this point there was diffuse generalized oozing from the tissues with no specific areas of bleeding that could be well visualized or controlled, and this continued throughout the case until the end of the case when the heparin was finally reversed. Topical thrombostatic agents were used intermittently, as well as packing with gauzes to help control bleeding, but a significant amount of blood loss occurred through the left groin throughout the course of the remainder of this case. Having corrected the left-sided inflow problems, handheld injections were used to visualize the runoff, which consisted of superficial femoral artery, popliteal, and 3-vessel runoff all the way to the ankle, all of which appeared be open with no critical lesions noted.