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Octopus endograft leak, stenting of LT renal artery component

Date: Sep 5, 2019

Question:

Would this be coded as a delayed graft extension 33886/75959/36247, or 37236/36247 for the IR physician? "History of thoracic aneurysm with Octopus graft, graft balloon component is outside LT renal artery causing type III leak. 3rd order arteriogram through LT renal artery Octopus graft in the type III endograft leak, stent LT renal artery with reapposition of thoracic octopus graft component into the LT renal artery. Stenting performed by IR physician and vascular surgeon. Vascular surgeon performed cutdown LT axillary artery. Access made into the LT axillary artery w/direct puncture. Negotiation into LT subclavian artery, descending thoracic aorta first using Omni Flush catheter within a RT lateral component of graft, ultimately into LT renal artery limb. Placement of a ViaBahn stent. Stent & LT renal graft component then lined with a self-expanding stent. The LT renal artery Octopus graft component is dislocated out of LT renal artery, causing type III leak. Stenting LT renal artery w/re-apposition of LT renal Octopus component into LT renal artery."

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