Ask Dr. Z

During the creation of an AV fistula my provider ligated two veins off the cephalic vein to aide in maturation of the fistula. He used two separate incisions to do so; is this billable? Here is an excerpt from the operative note: "The cephalic vein appeared to split into two veins in the proximal forearm with one coursing laterally and not being fairly superficial of excellent size. There were two branches connected to this vein. In order to allow maturity of this branch as well, I proceeded to make a very small stab just proximal to the entry of this branches to the cephalic vein, and these veins were clipped. Each small stab was closed with 1 interrupted 4-0 Monocryl suture."