AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 1; Ask the Editor

Aortocoronary Bypass Graft Utilizing Y-Graft

A patient with multi-vessel coronary artery disease was placed on cardiopulmonary bypass and underwent quadruple aortocoronary artery bypass, using the left internal mammary artery (LIMA) to the left anterior descending (LAD), and saphenous vein graft (SVG) to right posterior descending artery (RPDA), obtuse marginal (OM), and diagonal 1 (D1), utilizing Y graft. The left greater saphenous vein was harvested endoscopically. The RPDA, diagonal, and OM arteries were sequentially identified and autologous reverse saphenous vein was grafted end-to-side with each artery and brought to the ascending aorta. Then, the LIMA pedicle was grafted end-to-side over the distal to mid LAD. Proximal anastomosis between the vein graft and ascending aorta end-to-side configuration was done. OM graft proximal anastomosis was performed with SVG to the OM which was Y grafted to SVG to the D1 end-to-side configuration. What are the correct ICD-10-PCS codes for this surgery?  ...

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