Ask Dr. Z

Can you advise what code we should use on this case? We are not sure if 36245, 37236 or unlisted? "There is no occlusive disease present in the celiac. DX: Focal aortic dissection of the paravisceral abdominal aorta. Balloon angioplasty and stenting of the celiac origin to cover aortic fenestration feeding focal aortic dissection. Under ultrasound the right common femoral artery was percutaneously accessed using a 21 gauge MP set. This was transitioned over a Wholey wire to a 7 French sheath. Next, a 7.0 French Oscor twist conformable sheath was advanced over the Wholey wire from the right femoral into the abdominal aorta. A lateral aortogram was obtained, which revealed the location of the origin of the celiac artery with fast filling of a focal aortic dissection adjacent to the celiac artery origin. Next, the conf sheath and Wholey wire were used to selectively catheterize the celiac artery. Next, a 7 x 19 mm Gore VBX balloon-expandable covered stent was positioned across the origin of the celiac artery and successfully deployed."