Ask Dr. Z

My physician is stating that 34101 should be used since the thrombectomy was done via a brachial incision rather than just 34111. Thoughts?

"There was thrombus that could be seen in all 3 of these vessels. I then pulled up on the vessel loops on the brachial artery. I removed the stitches that were in the brachial artery arteriotomy and I passed #3 Fogarty thrombectomy catheter proximally for approximately 20 cm and pulled the clot out of the brachial artery until I had pulsatile inflow. I then retrograde flushed with heparinized saline. I then placed a Yasargil clamp on the brachial artery. I then took the vessel loops off tension on the ulnar artery and I passed #3 Fogarty balloon catheter down the radial artery for approximately 28 cm and pulled out clot 3 successive times. The fourth time I did not pull clot back. I then flushed with heparinized saline, but did not re-clamp the vessel. I then passed a #3 as well as #2 Fogarty thrombectomy catheter down the ulnar artery for approximately 20 cm."