Ask Dr. Z

"Removal of infected fem-pop bypass. Creation of ilio-profunda bypass w/cryo-preserved fem artery.Multiple stents were removed from pop artery w/no blood return from above-knee pop to suggest adequate revascularization.Tunnel was created w/end-to-side anastomosis with the segment of cryo-preserved fem artery to the profunda bypass.Graft was tunneled w/end-to-side anastomosis b/w the cryo-preserved fem artery and the above-the knee pop. GSV in upper thigh was harvested for 20cm. End-to-side anastomosis b/w cryo-preserved fem artery and reverse GS. Below knee pop was exposed. Then the vein was tunneled deep in the pop space w/end to side anastomosis b/w below knee pop and reverse GSV." 

Would this be considered a sequential composite graft (ilio-pop with vein) and add-on bypass graft, composite, prosthetic to vein (unlisted 37799, 35681), or would we look to multiple bypass codes? It reads like like multiple bypass grafts "jumping" off from one another.