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Subclavian saphenous vein graft repair

  1. #1
    Default Subclavian saphenous vein graft repair
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    I have a patient who was returned to the OR, 3 days after her original CABG. The original sx was done endoscopic. The physicians opened the previous subclavian incision and there was dehiscence of the anastomosis medially. He pulled the graft towards the incision more and devided a branch of the cephalic vein. Next the graft was tacked to one of the branches of the subclavian artery. This was followed by and end-to-end proximal vein graft to the subclavian artery anastomosis. There was also doppler signals in both the graft and subclavian artery distal to the anastomosis and in the saphenous vein. Then closed the facscia.

    I'm looking at 35002-78 for the procedure, and 93770-26 for the doppler scan. Can someone tell me if they come up with something different????
    Last edited by aguelfi; 11-30-2009 at 06:56 AM.
    adrianne, cpc

  2. Default
    CPT 35002 is for direct repair of a ruptured aneurysm, this wasn't an aneurysm. I think you would use code 35511-78 because they used a vein graft to bypass the dehiscence.

    I don't know the code for the doppler, my docs don't really do that.

    Lisi, CPC

  3. #3
    I agree with not using 35002, but I'm not sure of 35511 either. There is no mention of him harvesting a vein for a new graft, rather it sounds like he used the same graft and diverted it, end -to-side proximal vein graft to the subclavian artery.
    What about 35800.
    adrianne, cpc

  4. Default
    what did he do with the cephalic vein? Anyway, I would think 35800 would work.


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