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Are we able to bill for skin/soft tissue removal during aneurysmal repair of AV fistula? "Separate longitudinal incisions were made over these aneurysmal segments. Cephalic vein was identified and secured with silastic loops. The aneurysmal portions revealed thin vessel wall with compromised overlying soft tissue. Circumferential control was obtained. 5000 units of heparin were administered and allowed 3 minutes to circulate. The cephalic vein was clamped proximally and distally to the aneurysmal segments. A longitudinal venotomy was made over the compromised sites. Redundant compromised vessel wall was excised until a 2 cm residual diameter vein remained. Aneurysmorrhaphy was performed as the vein was then re-approximated using double layer 5-0 proline suture. Vascular clamps were removed. A thrill remained throughout the fistula. Compromised skin overlying the aneurysm was resected with a 15 blade. The amputated skin measured approximately 4 cm x 8cm. Deep dermis was approximated with interrupted 3-0 polysorb suture."