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The procedure described by CPT® Code 34501 refers to a valvuloplasty performed on the femoral vein. This surgical intervention is primarily indicated for patients suffering from valvular incompetence, a condition where the valves in the veins do not close properly, leading to blood pooling and potential complications such as venous ulceration. During the procedure, the surgeon exposes the femoral vein and carefully dissects the adventitia, which is the outer layer of the vein, to locate the valve commissures—the points where the valve leaflets meet. A marking suture is then placed at the commissure of the faulty valve to guide the subsequent surgical steps. A longitudinal incision is made in the vein, starting from a point distal (further away from the heart) to the valve and extending through the marking suture to a point proximal (closer to the heart) to the valve. This incision allows the vein to be laid open, and retention sutures are placed in the four corners of the incision to provide traction and maintain clear visibility of the valve during the repair process. The incompetent valve leaflets are then repaired to restore their normal cup-like configuration, which is essential for proper venous function. Finally, the femoral vein is closed, and the overlying tissues are repaired with sutures, completing the procedure and aiming to restore normal venous flow and alleviate symptoms associated with valvular incompetence.
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The procedure of valvuloplasty of the femoral vein is indicated for patients experiencing specific conditions related to venous health. These include:
The valvuloplasty procedure involves several critical steps to ensure effective repair of the incompetent valve. The process begins with the exposure of the femoral vein, which is essential for accessing the affected area. The surgeon carefully dissects the adventitia, the outer layer of the vein, to identify the valve commissures, which are the junctions where the valve leaflets meet. Once these commissures are located, a marking suture is placed at the commissure of the faulty valve to serve as a reference point for the incision. Following this, a longitudinal incision is made in the vein, starting from a point distal to the valve and extending through the marking suture to a point proximal to the valve. This incision allows the vein to be laid open, providing a clear view of the valve structure. To maintain exposure and facilitate the repair process, retention sutures are placed in the four corners of the incision, providing traction. The surgeon then repairs the incompetent valve leaflets, restoring their normal cup-like configuration, which is crucial for proper venous function. After the valve repair is completed, the femoral vein is closed, and the overlying tissues are meticulously repaired with sutures to ensure proper healing and restore the integrity of the surrounding anatomy.
After the valvuloplasty procedure, patients typically require monitoring for any immediate complications. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Patients are often advised to keep the surgical site clean and dry, and to watch for signs of infection or unusual swelling. Follow-up appointments are essential to assess the success of the procedure and to monitor for any recurrence of symptoms related to venous insufficiency. The expected recovery time may vary depending on the individual patient's health status and the extent of the procedure performed.
| Short Descr | REPAIR VALVE FEMORAL VEIN | Medium Descr | VALVULOPLASTY FEMORAL VEIN | Long Descr | Valvuloplasty, femoral vein | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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