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Hepatorenal Bypass Graft + Addition of Synthetic Bypass Graft

Date: Feb 6, 2015

Question:

"During the procedure the physician harvested the GSV and attempted to create a proper hepatic to right renal artery end-to-end bypass. The anastomosis was completed, but failed once, and following a revision and re-attempt was found to be too diminutive on arteriography and was removed and abandoned. A 6 mm PTFE bypass graft was then used as the conduit." My question is, with PFTE graft vs. 35535, should I report code 35535 alone with a -22 modifier (assuming documentation states as such) and/or another code for the PTFE graft that was ultimately left in place? (It appears that code 35535 only covers vein, and I cannot find a synthetic.) I would also like to code the arteriography (75726). What are your thoughts?

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