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35302 or 34201 & 35256: Embolectomy, Thrombectomy & GSV patch repair

Date: Aug 28, 2023

Question:

Please advise if documentation supports both 34201 & 35256 or 35302 only. Provider reported 34201 and 35256. 

Patient S/P TAVR w/occlusion of RT CFA/SFA @ site of closure device w/intimal disruption, dissection. Vertical incision made & closure device removed. Extended arterial puncture site w/Potts proximally then distally into the proximal SFA. Performed endarterectomy of CFA/SFA & tacked distal intimal edge w/multiple sutures w/sluggish backbleeding from SFA. Proceed w/FEM-POP catheter thrombectomy, #4 Fogarty thrombectomy, distally into SFA w/ retrieval of minimal thrombus. Segment not amenable to primary closure due to extent of arterial wall loss. Proceeded with harvesting of short segment of great saphenous vein. Vein graft sewn in place to the CFA/SFA in a patch angioplasty manner. Endarterectomized segment was flushed antegrade & retrograde prior to tying of our anastomosis. Closed the femoral sheath w/running 2/0 PDS. Closed the subcutaneous tissue in layers, closed the skin w/ running 4/0 Monocryl.

Question ID : 19340
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