Ask Dr. Z

Axillary bi-fem bypass was performed for infected aortitis Then through separate incisions an open lap was performed with excision of the infected aorta/iliac arteries. Would the excision of the infected aorta/iliacs be included in with the bypass procedure, or is it separately billable? If billable, how would you code this?

"Once we completed the axillary bifemoral bypass, we decided to resect the distal infrarenal aorta, aortic bifurcation, entire right common iliac artery, and proximal left common iliac artery. The tissue was sent for culture and pathology. We then performed further debridement along the left iliac vein and distal vena cava, confirming that all infected retroperitoneal peritoneal tissue was removed. We oversewed the right and left common iliac cuffs with a Blalock stitch, using 3-0 Prolene suture. The aortic cuff was oversewed in a similar fashion. We confirmed hemostasis. We then thoroughly irrigated the retroperitoneum with both saline and Betadine solution."