Ask Dr. Z

I have coded 35666 for the bypass and wanted to verify if I could use 35286/59 for the interposition graft placed in the CFA due to atherosclerosis? Thank you! a standard oblique incision was made in the right groin and carried down through the subcutaneous tissue through the previous scar down to the level of the common femoral artery. It was carefully dissected and encircled with a vessel loop, as well as the SFA and profunda femoris artery. The previous bypass grafts were also dissected free. Through a longitudinal incision below the knee, the posterior tibial artery was carefully dissected and encircled with vessel loops. The patient received 5000 units of heparin intravenous systemically. Clamps were placed on the common femoral artery. The grafts were detached from the previous artery. The artery had significant atherosclerotic disease. Therefore, an interposition graft was performed with a femoral interposition graft. We utilized an 8-mm PTFE graft sewn end-to-end and spatulated without difficulty with a running 6-0 Prolene suture flushing proximally and distally prior to completion. Complete inflow was restored. Next, clamps were reapplied to the common femoral artery. A 6-mm ring PTFE Propaten graft was sewn end-to-side to the common femoral artery flushing proximally and distally prior to completion. Complete inflow was restored. The graft was tunneled down subcutaneously to the posterior tibial artery and sewn end-to-side with a running 6-0 Prolene suture flushing proximally and distally prior to completion.