I have done simple vascular coding, but now have a general surgeon who specializes in vascular surgery. I need help w/below and also wondering if anyone can direct me to a source for coding guidelines. Below is my op I am struggling with.

Surgery is: left ileofemoral endarterectomy with profundoplsty and patch angioplasty of ileofemoral artery and repair of AV fistula. Op states there is fresh clot as well as plaque at the origin of profunda femoral artery. His arteriotomy extends from the external iliac down into the SFA. He performs atherectomy removing plaque from the proximal SFA, distal common femoral, profunda femoral and external iliac. Fistula at the common femoral artery is repaired externally. Patch was now brought in and placed over the profunda femoral, SFA and external iliac.

I am thinking because there is clot and plaque I should code the thromboendarterecomy codes, 35355, 35371, 35372 and 35190 for the fistula repair. If there was no clot, would I have then used the 3548X series of codes? Can you then code the patching separate? Code 35226 possibly? Sorry for all the questions, that is why I am in need of coding guidelines also. Thanks in advance for your help!!