Ask Dr. Z

My physician does the following on a previous common femoral to peroneal bypass using saphenous vein. Due to the vein graft stenosis a previous covered stent was placed in the distal portion of the bypass graft. The patient presented with exposure of the covered stent. My physician performed the following procedures: Revised the proximal saphenous vein anastomosis with interposition of a cryosaphenous vein graft at the anastomosis to upper thigh saphenous graft due to intimal hyperplasia of the proximal several inches of the saphenous vein graft. Revised the distal saphenous vein anastomosis with removal of the penetrating stent and interposition of cryosaphenous vein graft at the anastomosis up to the distal thigh saphenous vein graft with removal via catheter of thrombus from the peroneal down to the level of the ankle. I considered codes 35881 or 35876. Would I code it twice? Would I code removal of the stent separately and if so what code would I use? Since the thrombus removal was down to the ankle, would I code separately for that?