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Coronary artery bypass graft (CABG) is a surgical procedure aimed at improving blood flow to the heart by bypassing blocked or narrowed coronary arteries. This procedure utilizes a combination of venous and arterial grafts to create new pathways for blood to reach the heart muscle, which is essential for delivering oxygen and nutrients. The coronary arteries are responsible for supplying blood to the heart, and when these arteries become narrowed or blocked due to conditions such as atherosclerosis, it can lead to ischemic heart disease and potentially result in a myocardial infarction, commonly known as a heart attack. CABG is performed to reroute blood around these obstructions, thereby alleviating symptoms such as chest pain and reducing the risk of heart damage. During the procedure, surgeons typically harvest veins, often the greater saphenous veins from the legs, which are then prepared for grafting. The surgical process begins with an incision in the chest, followed by division of the sternum and retraction of the ribs to gain access to the heart. The surgery can be performed using two techniques: 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 heart is temporarily stopped and blood is rerouted through a heart-lung machine. The prepared vein grafts are meticulously sewn into place, with one end attached to the ascending aorta and the other end connected to the coronary artery beyond the site of blockage. This specific code, CPT® 33522, is designated for reporting the use of five venous grafts in conjunction with arterial grafts, which must be reported separately using the appropriate codes for accurate billing and documentation.
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Coronary artery bypass graft (CABG) surgery is indicated for patients who exhibit significant coronary artery disease, which may manifest through various symptoms and conditions. The following are the primary indications for performing this procedure:
The CABG procedure involves several critical steps to ensure successful grafting and restoration of blood flow to the heart. The following outlines the procedural steps involved:
After the CABG procedure, patients are typically monitored in a recovery unit for several hours to ensure stability. Post-operative care includes managing pain, monitoring vital signs, and assessing the function of the grafts. Patients may require a stay in the hospital for several days, during which they will receive medications to prevent blood clots and manage any discomfort. Rehabilitation and lifestyle modifications are crucial components of recovery, as patients are encouraged to engage in cardiac rehabilitation programs to improve their heart health and overall well-being. Follow-up appointments are essential to monitor the success of the grafts and to manage any ongoing cardiovascular risk factors.
| Short Descr | CABG ARTERY-VEIN FIVE | Medium Descr | CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN | Long Descr | Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 an add-on code that must be used in conjunction with one of these primary codes.
| 33533 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); single arterial graft | 33534 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts | 33535 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts | 33536 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts | 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) | 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) | 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) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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