Ask Dr. Z

"The patient underwent common femoral endarterectomy and left SFA to posterior tibial artery bypass graft earlier in the day. Patient now presents back in the OR later that day for lower extremity revascularization due to an acutely thrombosed bypass graft. LLE angiogram was performed. The left groin, thigh, and calf incisions were reopened and explored. Hematoma was evacuated from all three. Hemorrhage from the suture line of the proximal SFA anastomosis was controlled with Prolene suture. As it appeared there was adequate inflow in the superficial femoral artery and adequate outflow in the native posterior tibial artery. It was concluded based on imaging that the issue with the bypass was of conduit quality, and therefore a decision was made to revise the bypass by replacing the conduit."

The provider wants to report code 35860 in addition to the bypass graft revision code (for the exploration and evacuation of hematomas). Would this be considered bundled with the revision code? Or is it separately reportable with a -78 modifier?