My surgeon did a DIEP flap breast reconstruction with initial end-to-end anastamosis of the internal mammary artery and the DIEP artery. After about a half hour, the flap was having veinous congestion, so he harvested a graft from the scaphenous vein and used it as a vein graft to reconnect the internal mammary artery and the DIEP.

I have yet to find a description of code 19364 that includes a vein graft - is there a code that can be used? Maybe 35246-52 because the site is already open, and it is not intrathoracic? Or is it inherent to 19364 because the initial anastamosis failed and he had to use the graft for the flap to be successful?

Thanks in advance for comments and/or suggestions......