Ask Dr. Z

There is discussion about if the venous repair is billable for facility or pro fee. It centers around the "you break it, you buy it" rule that states that a surgeon cannot separately report (and receive compensation for treating) a complication during surgery if the complication occurs as a result of the surgery itself. What are your thoughts and rationale about this scenario? Patient had PPM generator and leads removed. Per report, "The leads exhibited calcification and significant lead-lead binding. The extraction process created a substantial tear in the axillary vein. This was managed by placing a 10 mm occlusion balloon via the femoral approach. After bleeding was controlled, the vein was repaired with 5-0 Prolene sutures over the inflated balloon." Is the axillary venous PTA billable? Is any of the vessel repair billable?