Ask Dr. Z

"MD previously did brachiocephalic fistula and failed, then MD did DRIL procedure and bypass failed. NOW, incision was made in skin down to subcutaneous tissue. Cephalic vein was identified. Dissected circumferentially and encircled with vessel loop. Old brachial-brachial bypass was thrombosed. It was dissected down to its end-end anastomosis to brachial artery distal. Artery also dissected distally to allow for control. Patient anticoagulated with heparin. Proximal brachial artery was controlled and cephalic vein distal to it transected beyond the arteriovenous anastomosis by about 2 cm. Distal cephalic vein overswen with 7-0 prolene suture. Old brachial-brachial bypass transected from brachial artery which was spatulated. Stump of cephalic vein was swung and anastomosed end-to-end to the brachial artery using 7-0 prolene suture. Flushing performed and flow established. Palpable pulse in brachial artery and triphasic Doppler signal in radial artery. Subcutaneous tissue approximated; patient had palpable pulse." Should we report 37607 (fistula ligation) and 35525 (brach-brach bypass surgery)?