Medical Record Preoperative Diagnoses : Critical aortic stenosis, CAD, hypertension, diabetes mellitus type 2 Postoperative Diagnoses: Same Procedure…

Medical Record

Preoperative Diagnoses: Critical aortic stenosis, CAD, hypertension, diabetes mellitus type 2

Postoperative Diagnoses: Same

Procedure : CABG x2

Operation: Coronary artery bypass graft x2 accomplished using reverse saphenous vein graft to the left anterior descending artery and reverse saphenouse vein graft to the obtuse marginal artery.

  1. Describe what information from the medical record above you think is important to help you find the correct code(s).
  2. List the procedure code(s) you would assign and explain why you chose the code(s) that you did.
  3. Describe each step you used to find the code(s) you chose for this case in the CPT manual.

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