Ask Dr. Z

I need your thoughts please. Patient has a thrombosed left fem-fem bypass. Surgeon knows this prior to surgery. He proceeds to perform a thrombectomy of the fem-fem bypass. Once this is completed, he notices significant irregularity just proximal to the distal anastomosis within the PTFE graft. He tried and could not get additional clot. He ends up ballooning and stenting this area due to residual stenosis. Because of inflow/outflow, I know I cannot bill for both the thrombectomy of the graft and the stent. Which one would you bill for? I chose the thrombectomy, 35875, over the stent, 37226. I interpreted the inflow/outflow to mean that once the surgeon performed the thrombectomy, any intervention performed to the artery above and/or below the graft (in this case the stent) would be content and not billable. Honestly, a person could talk themselves into billing either way. Can you explain how to interpret this so that I do not get confused in the future?