need 2 cpt codes
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Preop dx Arteriosclerotic heart disease Postop dx: SAME Procedure: Coronary Artery Bypass Graft x 4 Description of Procedure: The patient was brought to the OR and placed in the supine position. Anesthesia was administered. The patient was prepped and draped in the usual sterile fashion The sternum was opened through a midline incision. The saphenous vein was barvested from the left ankle. After the sternum was opened the pericardium was incised and the coronary field was carefully examined The mammary artery was taken down with cautery, Cardiopulmonary bypass was started. The patient’s core temperature was dropped to 30 degrees. The aorta was cross-clamped The acute marginal branch was grafted using portion of saphenous vein: the graft was brought up to the ascending aorta. The heart was tumed over: significant disease was seen in the proximal PDA.A segment of the saphenous vein was sewn in to this area with 7.0 Prolene to establish the bypass of this aren to the aorta Then the diagonal branch of the artery was grafted to the left mammary. The distal LAD was opened and grafted to the tip of the loft mammary. The two arterial grafts were completed The patient was rewarmed and the heart pinked up. The two vein graft clamps were released and filled well. There was no distal or proximal bleeding. The patient was paced into normal simus rhythm. The patient was disconnected from bypass. The aortic site was closed. The area was irrigated with antibiotic solution. The entrance incisions were closed, and the leg incision site was wrapped. The sternum was closed with wire and layered sutures The patient tolerated procedure well and was transferred to CICU HINT: What type of grafts are we using — arterial, venous or both? REMEMBER — Add-on codes are NEVER sequenced first! There are 2 codes needed for this scenario
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