Ask Dr. Z

"Patient scheduled for TAVR procedure. Cutdown was done on the right groin to expose the right femoral artery. The artery was very calcified, and there was no soft spot. Dissection was extended upwards and downwards to expose the common femoral artery as it went up more to the proximal to the inguinal ligament and all the way retroperitoneal to the external iliac artery. The artery was calcified throughout, and no access could be obtained. Both surgeons at this point agreed they could not proceed, and the incision was closed in layers of vicryl and monocryl. The decision to follow up with a subclavian percutaneous approach was made, and TAVR successfully placed at a later date."

Since 34812 is now an add-on code, would 33362-53 be appropriate? We are unable to bill anything but the incision and closure, as no angiography/catheterization procedure was performed.