AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2026 Issue 3; Ask the Editor

Saphenous Vein Graft Ligation

A patient presents for surgical intervention due to a known history of coronary artery aneurysm and fistulous connection between a large right tortuous coronary artery and the coronary sinus. The patient underwent a coronary artery bypass graft (CABG) with a saphenous vein graft to the right coronary artery. During surgery, the left greater saphenous vein was harvested endoscopically. A median sternotomy was performed, the fistulous connection was identified, and sutures were placed to close the fistulous connection to the coronary sinus.Next, the vein graft was spatulated and sewn to the most distal end of the right coronary artery and attached to the aorta. It was noted that the right coronary artery to the distal anastomosis was pressurizing. Because of this the vessel of the aneurysm sac was oversewn, a bulldog clamp was placed on the vein graft and sutures were used to oversew and obliterate the aneurysm. At this point, the vein graft was transected and taken off the aorta. What is the appropriate ICD-10-PCS code assignment(s) for placement of a CABG that is ligated/transected prior to closure? ...

Subscribe or sign in to view the full article.