Ask Dr. Z

Would you code this with 35141, 35142, or 35226? "Pre- and post-operative diagnosis: Pseudoaneurysm of right femoral bypass graft. Patient with history of of right femoral to tibial bypass graft with cryovein that was done four weeks ago. Patient presented today with acute bleeding episode. CTA confirmed arterial extravasation from the proximal aspect of the bypass graft. Previous groin incision was opened with a scalpel. The subcutaneous tissue was divided with electrocautery. The inguinal ligament was identified. Sharp dissection was used to clear the femoral artery. The bypass graft was palpable and clamped. Pressure was held proximally for control. There was a large defect in the anterior surface of the graft hood with active bleeding. It took several clamps to gain control. The defect was repaired with a running prolene suture. Clamps were removed. Pressure raised, and there was no active bleeding. Wound was irrigated. Tissues were re-approximated in layers. Skin was re-approximated with nylon. A closed suction dressing was placed."