Ask Dr. Z

"Patient presents with AAA as well as bilateral common iliac artery aneurysms that involve bilateral common iliac artery bifurcations. The patient's bilateral common iliac aneurysms are not amenable to standard endo-grafting and will require the use of a Gore iliac branched endoprosthesis to obtain a seal, as well as to maintain preservation of flow into the internal iliac arteries. Our physician did EVAR with an aortic endoprosthesis with two docking limbs, distal extension into external iliac artery of endoprosthesis on right side, distal extension of endoprosthesis, internal iliac on right side, distal extension into external iliac of endoprosthesis on left side, and distal extension into internal iliac with distal endoprosthesis extension on left side." This is the first time we have done this with four extensions. What is the best way to code these?