Ask Dr. Z

In this case would we be okay to report 35082, Ruptured AAA of Abdominal Aorta (8CM)- Procedures performed were - Open exploration of the abdomen, lysis of adhesions, pigtail cath of aorta w/AO Gram, bilateral fem sheaths (12 R 6LT) They clamp Aorta proximal and distal to ruptured aneurysm, ligate bleeding lumbars , incise the sac which has a hole in it, Drain the intramural thrombus, and then they suture the aortic sac with proline and close the abdomen. They placed the sheaths and the pigtail because they were considering doing an Endovascular approach (patient has prior endograft) but they did not attempt to place and EVAR. As they felt it would not suffice and patient was already ruptured . Thus I don’t think this would qualify for 34830. Since the open aneurysm repair codes are with or w/o graft insertion and all of the work described outside of placing a graft describes 35082. Would it be appropriate? Or would we instead report Ligation 37617. And exploratory lap? Or am I just way off all around?!