Ask Dr. Z

I am billing unlisted code 37799 for vena cava resection and reconstruction. What code(s) do you recommend comparing this to in order to send description to carrier and to help calculate the fee?

"We began to resect the medial aspect of the IVC using a combination of Potts and Metzenbaum scissors. The tumor did extend cephalad and encroached upon the Rummel tourniquet and thus we replaced the cephalad Rummel tourniquet with a Satinsky clamp. We completed the caval resection with the assistance of our urologic colleagues, and when we are both in agreement that all gross tumor was resected we evaluated our options regarding primary caval closure versus patch venoplasty. Given the amount of medial caval wall that was resected, we elected to pursue patch venoplasty with a bovine pericardial patch. We performed a patch venoplasty in a running fashion using 4-0 Prolene."