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Confusing Surgery Scenario

Date: Oct 18, 2021

Question:

Coding for pro-fee here for procedure performed in a hospital by multiple physicians, but only coding for the vascular surgeons.

Vascular Surgeon A places a bypass graft from the external iliac to the SFA (35665), and then turned the case over to surgical oncology surgeon for tumor resection, who then turns the case over to plastic surgeon for reconstruction post tumor resection. The plastic surgeon noticed that there was no longer a palpable thrill in the graft that Vascular Surgeon A placed, but Vascular Surgeon A was no longer available, so Vascular Surgeon B came in and created a new incision and performed an open embolectomy of the graft and then placed a stent in the proximal anastomosis (35876). Since the embolectomy was performed at the same surgical session as the placement of the bypass, but after the first vascular surgeon turned the case over to surgical oncology, can we code both codes or is it all included in 35665? If we can't, since both surgeons are in the same specialty/same group same group, would the second surgeon get an 80?

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