Ask Dr. Z

What is the correct coding for the vascular surgeon, vein repair only? "I was called to the OR for intraop. consult by Dr. X. He was performing enblock resection of pancreatic mass of the distal pancreas, mass is too close to the porta vessels and the celiac axis. The Portal v. was controlled; Splenic v. was ligated both proximally and distally and divided. Because of all the desmoplastic reaction, while dividing the Splenic v. off of the Portal v. confluence we noted a defect about 2.5 cm in length, manual compression we had control of the vein; I dissected the proximal and distal ends of the Portal v. and the SMV inflow to the vein. The defect was dissected and isolated, repaired with a 4-0 prolene suture in double layer running fashion with excellent hemostasis and good venous filling post repair. Our dissection was continued laterally to skeletonize the Common Hepatic a. and the LT Gastric a. at the level of the Celiac, extensive lymphadenectomy was completed at this level. The Splenic a. was identified divided and ligated, then mobilized the entire pancreas and spleen dividing all of its attachments and passed off the field."