Ask Dr. Z

Would you code for the ligation of the vein graft in this situation? If so what code? "The scar from the proximal anastomosis of the bypass was reopened and the vein graft dissected out from the hood of the anastomosis for the length of the incision. The graft appeared thickend and thrombosed, and absence of a signal was confirmed with Doppler. Vessel loops were placed around the vein graft. A 3 French thrombectomy catheter was passed proximally into the femoral artery and inflow established, but the graft was clearly stenotic proximally. This was confirmed by opening the graftotomy longitudinally and more proximally. Similarly, the thrombectomy catheter was passed distally, but repeatedly met obstruction below the knee, and liquified thrombus extracted. As it was clear that endovascular therapy was futile, and that a repeat bypass would be necessary, we abandoned today's attempt at revascularization. The vein graft was ligated proximally and distally to the graftotomy. Once hemostasis was adequate, the deep and supeficial fascia were closed."