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The coronary arteries are vital blood vessels that supply oxygen and nutrients to the heart muscle. When these arteries become narrowed or blocked due to conditions such as atherosclerosis, it can lead to ischemic heart disease, which may result in chest pain (angina) or myocardial infarction (heart attack). To address these issues, a surgical procedure known as coronary artery bypass grafting (CABG) is performed. This procedure aims to reroute blood flow around the obstructed or narrowed sections of the coronary arteries, thereby restoring adequate blood supply to the heart. In the case of CPT® Code 33516, the procedure specifically involves the use of veins, typically harvested from the greater saphenous veins located in the legs. The surgical process begins with the harvesting of these veins, which may require incisions in the thigh or calf. Following this, an incision is made in the chest to access the heart, where the sternum is divided, and the ribs are retracted to provide a clear view of the heart. The CABG can be performed using either the off-pump coronary artery bypass (OPCAB) technique, which allows the surgery to be conducted on a beating heart, or through cardiopulmonary bypass, where the patient is connected to a heart-lung machine. The prepared vein grafts are then meticulously sewn into place, connecting one end to the ascending aorta and the other to the coronary artery beyond the blockage. This specific code, 33516, is designated for cases where six or more venous grafts are utilized in the bypass procedure, highlighting the complexity and extent of the surgical intervention required to restore proper blood flow to the heart.
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The procedure is indicated for patients with significant coronary artery disease characterized by the following conditions:
The coronary artery bypass grafting (CABG) procedure involves several critical steps to ensure successful revascularization of the heart. The first step is the harvesting of the vein grafts, typically the greater saphenous veins from the legs. This requires making incisions in the thigh or calf to access the veins, which are then carefully removed and prepared for grafting. Following vein harvesting, the surgical team makes an incision in the chest to access the heart. The sternum is divided, and the ribs are retracted to provide a clear view of the heart. At this point, the surgical approach can vary; the procedure may be performed using the off-pump coronary artery bypass (OPCAB) technique, which allows the surgery to be conducted on a beating heart, or through cardiopulmonary bypass, where the patient is connected to a heart-lung machine to take over the function of the heart and lungs during the surgery. If the OPCAB technique is utilized, medication is administered to slow the heart rate, facilitating the surgical process. Once the appropriate technique is established, the prepared vein grafts are sewn into place, with one end of each graft attached to the ascending aorta and the other end connected to the diseased coronary artery beyond the blockage. This meticulous process is repeated for each graft, ensuring that six or more venous grafts are utilized in accordance with CPT® Code 33516. After all grafts are in place, if cardiopulmonary bypass was used, it is then discontinued, and the heart is allowed to resume its normal function.
Post-procedure care for patients undergoing CABG with six or more venous grafts includes close monitoring in a recovery unit to assess heart function and ensure stability. Patients may experience pain and discomfort at the incision sites, which can be managed with appropriate pain relief medications. Rehabilitation typically begins shortly after surgery, focusing on gradually increasing physical activity to promote recovery. Patients are also monitored for potential complications, such as infection, bleeding, or graft failure. Follow-up appointments are essential to evaluate the success of the grafts and the overall health of the patient, ensuring that any issues are addressed promptly.
| Short Descr | CABG VEIN SIX OR MORE | Medium Descr | CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT | Long Descr | Coronary artery bypass, vein only; 6 or more coronary venous grafts | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2A - Major procedure, cardiovascular-CABG | MUE | 1 | CCS Clinical Classification | 44 - Coronary artery bypass graft (CABG) |
This is a primary code that can be used with these additional add-on codes.
| 33141 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure) | 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33258 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure) | 33259 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure) | 33508 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure) | 33530 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) | 33572 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List separately in addition to primary procedure) | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure) | 35500 | Addon Code MPFS Status: Active Code APC N CPT Assistant Article Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure) | 35572 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure) |
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| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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