© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 34502 refers to the reconstruction of the vena cava, which is a major vein responsible for returning deoxygenated blood to the heart. This procedure is typically indicated in cases of malignant invasion, where cancerous growths compromise the integrity of the vena cava, necessitating resection and subsequent reconstruction. Other reasons for performing this procedure include the presence of saccular aneurysms, congenital malformations, or traumatic injuries that affect the vena cava. The specific approach to reconstruction is determined by whether the superior or inferior vena cava is involved and the precise location of the lesion, defect, malformation, or injury. During the reconstruction process, various techniques may be employed depending on the extent of the damage. For minimal defects, direct suture repair may be sufficient. In cases where a longitudinal resection is required, an interposition graft may be utilized to bridge the gap. If a segment of the vessel is excised, a tubular graft may be necessary to restore continuity. The surgical procedure involves careful exposure of the vena cava, and if the resection is due to malignant invasion, the surgeon will excise the lesion along with a margin of healthy tissue to ensure complete removal of cancerous cells. In instances of aneurysms, malformations, or traumatic injuries, the affected segment of the vena cava is removed, and the reconstruction is performed using techniques such as running sutures, vascular staplers, or grafts made from synthetic materials, bovine pericardium, or the patient's own pericardium. This comprehensive approach aims to restore the function of the vena cava while minimizing complications and ensuring patient safety.
© Copyright 2025 Coding Ahead. All rights reserved.
The reconstruction of the vena cava, as described by CPT® Code 34502, is indicated in several specific clinical scenarios. These include:
The procedure for the reconstruction of the vena cava involves several critical steps, which are detailed as follows:
Post-procedure care following the reconstruction of the vena cava is crucial for ensuring proper recovery and minimizing complications. Patients are typically monitored closely for any signs of bleeding, infection, or complications related to the graft or repair. Follow-up imaging studies may be performed to assess the integrity of the reconstruction and ensure that blood flow through the vena cava is restored. Patients may also require pain management and supportive care during their recovery period. The expected recovery time can vary based on the extent of the surgery and the patient's overall health, but careful adherence to post-operative instructions is essential for optimal outcomes.
| Short Descr | RECONSTRUCT VENA CAVA | Medium Descr | RECONSTRUCTION VENA CAVA ANY METHOD | Long Descr | Reconstruction of vena cava, any method | 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) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
This is a primary code that can be used with these additional add-on codes.
| 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) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.