[Solved]: INSTRUCTIONS: Assign ICD-10-PCS codes to the…

INSTRUCTIONS: Assign ICD-10-PCS codes to the following case study. NOTE: do not code the operative aortogram or angiography included with this case. PREOPERATIVE DIAGNOSIS: A 9 cm infrarenal abdominal aortic aneurysm POSTOPERATIVE DIAGNOSIS: Same PROCEDURE: Endovascular repair of abdominal aortic aneurysm with Gore excluder graft HISTORY: This is an 87-year-old male who presented to the ER with back pain. He was diagnosed with a large AAA that was asymptomatic in incidental finding. He was transferred to ABC Hospital for treatment. CT scan revealed a neck that was less than 15 mm, but greater than 1 cm with approximately a 50-degree angulation of the neck. Because of the patient’s age, it was felt that endovascular repair would be the best situation for this patient. After informed consent was obtained from the patient’s family, they agreed and wished to proceed. In the operating room, transverse groin incisions were made in the common femoral and profunda femoral. Superficial femoral arteries were dissected off. Control was obtained. Subsequently on the right, an entry needle was used to access the femoral artery. A guidewire was introduced and a 5-French sheath introduced. Subsequently, a Percor catheter was introduced into the aorta and an aortogram was performed. This revealed patent bilateral renal arteries. Mesenteric artery was patent. The neck of the aneurysm was visible approximately a centimeter and a half below the left renal artery. The large aneurysmal sac was visible as well as bilateral iliac arteries, which were patent. Subsequently, an Amplatz wire was inserted and the 5-French sheath was exchanged for in 18-French sheath. On the left side, the common femoral artery was accessed with an entry needle. A guidewire was introduced and a 5-French sheath introduced. An Amplatz wire was introduced and 5-French sheath was then exchanged for a 12-French sheath. Subsequently to the right, a 26 x 14 x 14 Gore excluder main body trunk was inserted. This was measured from a previous CT scan. After angiographic localization of the left renal artery, the graft was deployed with excellent apposition to the wall, even though there was some tortuosity. The graft was then fully deployed. In order to anchor the graft on the right, the ipsilateral limb was inserted after localization of the hypogastric arteries. In 18 x 10 ipsilateral Gore excluder then was inserted and deployed with appropriate overlap. Subsequently, the left gate was cannulated. Confirmation of cannulation was obtained by spinning a pigtail catheter within the neck of the aneurysm. On the left, after angiographic localization of the hypogastric arteries, and 18 x 14 contralateral limb was inserted and deployed with appropriate overlap. Subsequently, balloon was inserted and the proximal distal attachment sites were ballooned as well as the floor divided. A completion angiogram revealed excellent flow through the excluder graft with no 1 endo leak. There were multiple arteries visible; however, the aneurysm sac did not fill. The sheath was then withdrawn. The bilateral common femoral arteries were repaired with 5-0 Prolene sutures. There were good Doppler signals distal to the repair with triphasic flow. The groin wounds were irrigated and closed in two layers with3-0 Vicryl and4-0 Monocryl subcuticular for the skin. All instrument counts and sponge counts were correct as per the nursing staff. The patient was extubated and transferred to recovery in stable condition. Principal procedure code: