Ask Dr. Z

I am not sure if this would be an aneurysm repair (35011) or a revision (36832). What are your thoughts?

"The skin over the left arm distal to the aneurysmal portion was instilled with lidocaine. The skin was cut with a 15 blade and deepened with electrocautery. The fistula near the arterial anastomosis at the antecubital crease was controlled with clamp. The fistula near the arterial anastomosis was ligated with 5-0 Prolene in double layers. The aneurysmal portion of the fistula including the overlying skin was resected sharply with scissors. The vein in the proximal arm was also ligated with 5-0 Prolene suture in double layers. Hemostasis was achieved. The incision was closed in layers with 3-0 PDS sutures, and the skin was now closed with 4-0 Nylon sutures and staples. A sterile, occlusive dressing was placed."