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Wiki repair of artery w/removal percutaneous vad

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churst21

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So my doctor started placing impellas into the subclavin artery. He is a chimney graft onto the subclavian artery to place the device.

The patient comes back later he places an implantable vad and removes the impella, removed the graft. Takes a piece of the graft sews it the subclavian to repair the artery.

Can cpt 35276 be used to the repair artery or would the repair be part of the removal.

I can't find anything online
 
that's a tough situation. I always think of the repair codes as designed for trauma or defects and in this case it is a physician created hole which is being repaired so I would be hesitant to use the 35xxx codes. Honestly I don't know what the best solution is but I would lean towards considering it a routine closure and not separately billable during Impella and VAD exchanges.
 
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