A patient with coronary artery disease presents for three-vessel aortocoronary artery bypass graft surgery. After sternotomy, reverse saphenous vein aortocoronary anastomoses were completed from the ascending aorta to the right coronary artery (RCA) and to the obtuse marginal (OM) artery. After obtaining a left internal mammary artery (LIMA) free graft, the distal end of the graft was anastomosed to the left anterior descending artery (LAD) and the proximal end was anastomosed to the hood of the completed vein graft anastomosis at the OM. What is the appropriate qualifier value for bypass grafting using the LIMA as a free graft between the LAD and the OM vein graft?
Assign the following ICD-10-PCS code:
In this case, the obtuse marginal saphenous vein graft is functioning as a coronary artery. The LIMA graft allows blood flow from the functional coronary artery to the LAD. The ICD-10-PCS Official Guidelines for Coding and Reporting guideline B3.6a states that the qualifier value specifies the vessel bypassed from, therefore, qualifier “3, Coronary artery” is assigned.