AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 1; Ask the Editor

Carotid Artery Endarterectomy with Imbrication

A patient with left carotid artery occlusion underwent left internal and common carotid artery endarterectomy with internal carotid artery imbrication due to carotid loop. At surgery, an arteriotomy of the common carotid artery was made and extended across the bulb through the level of the internal carotid artery where critical stenotic plaque was noted. The endarterectomy plane was established in the bulb and was extended retrograde in the common carotid artery where the plaque was transected. Eversion endarterectomy was performed in the external system and the plaque was then elevated out of the remainder of the internal carotid artery. Due to carotid loop, the internal carotid artery was imbricated with Prolene to shorten the length so that there would not be a loop. The arteriotomy was then closed with a bovine pericardial patch using running 6-0 Prolene. What is the correct root operation for the imbrication, Restriction or Repair? ...

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