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Foreign Body Retrieval with Cutdown

Date: Jun 27, 2022

Question:

I’m not really sure how to code this. Would this still code to 37197 even though a cutdown was performed?

"Angio demonstrates a RFB extending from distal ext iliac into thrombosed pseudoaneurysm. 6 French sheath advanced over g-wire to left external iliac proximal to the RFB. Multiple attempts to snare the FB was unsuccessful as FB incorporated the vessel wall of the external iliac. Elected to remove via cutdown. Under u/s guidance RFB extended into the thrombosed left groin  pseudoaneurysm closest. Stab incision made using 11 blade. Grasped the foreign body and carefully remove it while applying pressure over the arteriotomy site. A flow-limiting dissection in the distal left external iliac at point of proximal attachment of the foreign body. There was little distal  flow to the dissection. 4 French catheter was advanced over g-wire, contrast confirm position of cath. G-wire was readvanced. Attempt to treat dissection with prolonged inflation and 8 mm balloon. Some improvement post prolonged inflation, but dissection flap persisted and hemodynamically compromising. Repair with 10 x 30 Protege stent."

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