Ask Dr. Z

Physician requested 37799 and 36831 for thrombectomy of AVG that was ultimately excised.

"1 month s/p a left AV graft that initially had a good thrill but in post op visit was noted to thrombus"

"I made a transverse incision along the course of the graft. I placed a 3, 4, and 6 Fogarty through the outflow of the graft. I was able to get excellent back bleeding. I then attempted to pass a fogarty through the arterial anastomosis into the brachial artery. I was able to get some forward bleeding but was not significant enough to support a graft.

I thus decided that the graft was not salvageable and resected the exposed portion.

The wound was irrigated and closed in layers. . The patient tolerated the procedure well and went to recovery room in stable condition for later discharge home the same day.

Would both codes be appropriate? or would this just be an unlisted code for excision of graft without infection?