Ask Dr. Z

The physician performed thrombectomy on a patient with axillary-femoral graft. Physician accessed with two incisions. Would this be billed with a modifier -22? Would you bill 35875 x2? We want to be sure we cover the work for two incisions. Here is that part of the op report.

"A longitudinal incision made on the left abdomen overlying the distal axillary graft. Dissection to graft. Proximal and distal control obtained. Transverse graftotomy made. 5 French graft thrombectomy catheter passed proximally removing acute clot as well as well formed chronic clot (right limb). (Physician proceeded to remove clots and close)

A transverse incision made on the right lower abdomen overlying the distal femoral limb of graft. This site was not over the right anastomosis but rather 10 cm proximal. Dissection to graft. Proximal and distal control obtained. Transverse graftotomy made. 5 French Fogarty balloon catheter passed proximally removing acute clot as well as well formed chronic clot (left limb)." (Physician proceeded to remove clots and close.)