Ask Dr. Z

"Patient with an infected right common iliac artery contained aneurysm. The physician placed a left axillary bi-femoral bypass. He then entered the abdomen, clamped inferior to the inferior mesenteric artery, and identified the left common iliac. Placed clamps proximally and distally and removed stent. Oversewed the left external iliac and common iliac. Entered the aneurysm in the right common iliac and found pus within the arterial wall. Resected all purulent portions of the wall and debrided the retroperitoneum. Gained distal control with Fogarty catheter. Oversewed the right external iiac. Divided and resected the aorta going proximally, oversewed the lumbar arteries. He teed off the aorta just distal to the inferior mesenteric artery and performed two-layer closure." Would 35131 direct repair aneurysm and graft insertion iliac artery be correct? Since aneurysm was in the iliac artery I didn’t think 35102 would be correct. Can the left iliac stent removal be coded, or would that be included? What are your thoughts on this?