AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 1; Ask the Editor

Iliofemoral Endarterectomy and Furthest Point of Entry

The patient had calcified plaque involving the entire common femoral artery, extending into bilateral distal external iliac arteries, with stenotic lesions in the profunda femoris and superficial femoral arteries. The surgeon performed bilateral iliofemoral profunda femoris endarterectomy with a patch graft. During surgery, distal dissection of the external iliac artery was carried out bilaterally. Arteriotomy was made in the common femoral artery and plaque was removed. The external iliac, proximal common femoral and profunda femoris arteries were endarterectomized, with an eversion technique to the external iliac and common femoral arteries. The arteriotomy was then extended into the superficial femoral artery, atheromatous plaque was removed and Bovine pericardial patch was fashioned. When assigning ICD-10-PCS codes, what is considered the most proximal site (i.e., the most proximal site of surgical dissection or the most proximal anatomic site of the vessel)? ...

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