Ask Dr. Z

How would you bill for ligation of axillary vein and its tributaries to control bleeding from a gunshot wound?

Procedure in detail: Patient's right anterolateral thoracotomy generously exposed the third portion of the axilla and the axillary artery and vein. Myriad tributaries and the axillary vein itself were lacerated, both by direct impact and cavitation. Serial Prolene 4-0 sutures over sewed, ligated the venous tributaries, as well as the anteromedial wall of the axillary vein itself. Copious irrigation was used. Hæmostasis was achieved, though the pectoral muscles (minor and major) were injured from the GSW blast. The axillary artery was palpated, and no overt injury was noted. Closure is under the ægis of Dr. X.