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I appreciate your feedback on the following question regarding billing of two MitraClips. "PROCEDURAL DETAILS: 1) 7 French sheath was placed in the right femoral vein. 2) A Baim-Turi catheter was used to perform right heart catheterization. 3) Using TEE guidance, transseptal access was performed using lamp 45 catheter and BRK1 needle. 4) The lamp catheter was used to position an Amplatz Super Stiff wire in left upper pulmonary vein. The dermotomy was enlarged with a 16 French sheath. A 24 French clip delivery sheath was inserted into left atrium. 5) MitraClip was advanced into left ventricle. After several attempted grasps, A2 and P2 were successfully approximated slightly medial to midline of the line of coaptation. This resulted in reduction of MR from 4+ to 3+ with no change in transmitral gradient. The clip was deployed. A second clip was positioned just lateral to the first clip and grasped A2-P2 relatively easily. MR reduced to 1+ with no change in transmitral gradient. The second clip was deployed."