AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2022 Issue 3; Ask the Editor

Aortoiliac Aneurysm Repair

A patient underwent an open aortoiliac aneurysm repair. During the procedure, the aortoiliac bifurcation was dissected free down to the iliac bifurcation points. Both common iliacs were noted to be densely calcified with a palpable stent in the right common iliac and an aneurysm in the left common iliac. At the left iliac bifurcation, the external and internal iliac arteries were separately dissected free. The infrarenal abdominal aorta was dissected free, skeletonized and circumscribed. The aneurysm was opened. A Dacron bifurcation graft was sewn end-to-end to the infrarenal abdominal aorta. Next, the left common iliac bifurcation was endarterectomized to enable suture to this bifurcation. The right limb of the Dacron graft was tunneled anatomically beneath both ureters, down to the right groin and sewn end-to-side to an arteriotomy in the common femoral artery. Flow was restored to the internal iliac on the left and the profunda femoris on the right. What are the appropriate ICD-10-PCS codes for the aortoiliac aneurysm repair? In this case, would replacement or bypass be assigned as the root operation or a combination of these root operations? ...

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