Some of my physicians perform the ‘elephant trunk procedure’ which includes replacing the ascending aorta and a total arch replacement with reimplantation of the head vessels. We have a new code for hemiarch but the total arch can no longer be billed with ascending. With this procedure another graft is anastamosed to the distal end of the arch graft so that the descending aorta can then also be replaced by endograft. Ascending, arch and descending aorta are all replaced. Any CT surgery coders out there who think this ban is a mistake?