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EIA, CF, DF, SFA were dissected free, vessel loops proximally and distally, branches, pulled taut. Cooley clamp placed on EIA, 11-blade used to create arteriotomy in SFA, carried proximally onto the CF to the proximal CF artery. Total arteriotomy was approximately 8 cm. SFA endarterectomy performed. Distal end points tacked down w/sutures. Iliofemoral endart performed. Eversion was taken more proximal to the arteriotomy and up to the clamp. Iliofemoral endart was completed. 8-cm long arteriotomy and 0.8 x 8 cm Bovine patch was sewen into place using suture x 2. Patch went onto SFA approximately 3 cm.

Dr. wants to bill all 3 Endarterectomies-his response- Separate skin incision or separate artery incisions? Each artery is distinct/separate from the other arteries. Difference in work between a single iliofemoral endart vs a iliofemoral, superficial femoral endart, and deep femoral endart is extremely significant. Easily double the time of the procedure. They are separate arteries with separate CPT’s. Please help explain, 1 or 3 to be billed out?