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Aorto-SMA, Aorto-Common hepatic, Aorto-Splenic artery Bypass grafts

Date: Dec 3, 2021

Question:

Patient with complete occlusion of her SMA with very heavy calcific plaque and pseudoaneurysm with the celiac artery.

"...Supraceliac aorta clamped. Aortotomy completed and minimal thrombus present, removed. End to side proximal anastomosis of cryo preserved SFA graft completed. Aortic clamps removed. Graft was distended and passed into tunnel with aortic clamp and retrieved at the base of the transverse mesocolon. Ends were spatulated and end to side anastomosis completed to the SMA. The proximal segment of the graft was then controlled and one additional segment of cryo preserved femoral artery was sutured end to side and was then distended and anastomosed end to end to the common hepatic artery. An additional segment was sutured to this jump graft. End to end anastomosis between the cryo preserved femoral artery and the splenic artery was created."

Are these considered three separate bypass grafts as the provider listed and if so are we looking to 35631 (aorto-SMA) and then unlisted x 2 for the other two? Your thoughts are appreciated.

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