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The vascular doc exposed right neck external jugular vein, and the harvested saphenous vein graft was transferred to neck, where the anastomosis between the saphenous vein graft and external jugular vein was performed. At that point the plastic surgeon did a muscle flap using latissimus dorsi muscle and eventually attached the thoracodorsal vein anastomosis with the saphenous vein graft. This created a bridge for the gap between the neck and preauricular flap for the cranial defect. All our vascular doc did was the saphenous vein harvest and anastomosis to the external jugular vein. We have no clue how to code this! Help would be appreciated!