Ask Dr. Z

"Patient admitted for EVAR for iliac aneurysm on the back drop of an aortic dissection where a steel core wire was advanced to the thoracic aorta and through the false lumen in right lower extremity. A 31 gooseneck snare was used to capture the steel core wire and externalized through the right femoral sheath. A pair of 6-French Raabe sheaths were advanced to top of wire crown then proceeded to fenestrate dissection plane by pulling the sheaths and wire distally from just below the left renal artery to iliac bifurcation. Wires were then directed to the true lumen from both fem sheaths to thoracic aorta where a 31 mm x 14.5 mm x 13 cm Gore ipsilateral trunk device was deployed through right femoral sheath at a position below the renal arteries and extended with 14.5 mm x 13 cm iliac limb extender down to right external iliac. Through contralateral sheath a 23 mm x 10 cm contralateral limb was deployed in over lapping fashion." How would you recommend coding this case?