Ask Dr. Z

Would the profunda reimplantation to the graft be part of establishing inflow/outflow in code 35141 or would this be separately billable with a 22 mod or unlisted 37799?

"Patient has right CFA aneurysm with complete occlusion of right SFA and profunda femoris. We dissected the CFA proximal to the aneurysmal area. The vessel was encircled with a vessel loop and controlled. We repeated the same process for the SFA and profunda. The aneurysm was then entered anterior arteriotomy with a 11 blade. The arteriotomy was extended proximal and distal with scissors. We completely transected the proximal and distal ends of the affected artery in order to proceed with reconstruction. An 8 mm Dacron graft was sewn to the CFA in an end to end fashion. The same process was repeated for the distal anastomosis to the SFA. Next, the profunda was transected and ligated. The distal portion was mobilized in order to anastomose to the Dacron graft. End to side anastomosis with 5-0 Prolene was performed. All the arteries were flushed prior to completing the anastomosis."