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Ligation Vs. Direct Suture Repair of Mesenteric Bleed due to MVA.

Date: Apr 2, 2021

Question:

I have a case where a trauma surgeon (not part of of our group) performed an exp lap with drainage of hemoperitoneum, with packing. No bowel resection. He called our vascular surgeon in to control bleeding for a branch of the SMA. Our surgeon, from what I can tell, ligated the SMA branch and suture repaired it. Our surgeon said ligation only in procedures performed. What are your opinions between coding 37617 vs. 35221? Since he suture repaired the artery after he first ligated the branch and waited 30 minutes I am thinking 35221. I also considered 44850 since the main surgeon did not do anything more invasive beyond exp lap and drainage, but our surgeon only repaired or ligated the vessel?

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