Ask Dr. Z

Please do NOT include any actual patient medical records with your question. I have a surgery that I have never coded before and I am lost on this area. patient has Subclavian Steel syndrome with significant stenosis of left common carotid and innominate artery. Surgery performed was Resection of the aortic arch and head vessels with debrancing of the head vessels. resection of left subclavian artery with graft, resection of left common carotid artery origin with graft, innominate resection of origin with graft. Patient was cooled and circulartory arrested, placed on bypass. carotid and subclavian endarterectomized. Resected aortic arch in a patch fashion and resected the head vessels. we selected out a trifurcated 30 mm branch graft and created a nice patch with the head vessel branch grafts intact. 30 mm and 10 mm innominate, and 8 mm left cartoid and left subclavian branch graft. With the arch anastomosis completed we placed bioglue around to seal all suture lines. I think the 35301 for carotid endartectomy would be correct and 35311 for the subclavian and 35311-59 for the inominate. I am totally at loss for the Aortic resection and the debranching. Can you guide me. I may be totally off on this one. Thank you.