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A cross-over vein graft to the venous system is a surgical procedure designed to redirect blood flow around obstructed veins in one leg by utilizing healthy veins from the opposite leg. This procedure is particularly beneficial for patients experiencing venous insufficiency or other conditions that lead to obstruction in the venous system. The process begins with an incision made below the area of obstruction on the affected leg, allowing access to the obstructed vein. A second incision is then created in the groin area of the opposite leg, where a subcutaneous tunnel is formed across the suprapubic region and extended along the subsartorial region of the symptomatic leg. This tunneling is essential for positioning the harvested vein without causing additional trauma to the surrounding tissues. The saphenous vein, which is a large vein located in the leg, is carefully dissected from its surrounding tissues on the healthy side, and its tributaries are ligated to prevent blood loss. Once a sufficient length of the saphenous vein is obtained, it is cut at the distal end. The harvested saphenous vein is then tunneled to the site of obstruction on the symptomatic leg. The obstructed vein is clamped and incised below the obstruction, allowing for the creation of an end-to-side anastomosis, which connects the healthy saphenous vein to the obstructed vein, thereby restoring proper blood flow and alleviating symptoms associated with venous obstruction.
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The cross-over vein graft to the venous system is indicated for patients with specific conditions that lead to venous obstruction. These indications include:
The procedure for a cross-over vein graft to the venous system involves several critical steps, each designed to ensure the successful rerouting of blood flow. The steps are as follows:
After the cross-over vein graft procedure, patients typically require monitoring for any complications, such as bleeding or infection at the incision sites. Post-operative care may include pain management, elevation of the affected leg to reduce swelling, and gradual mobilization to promote healing. Patients are often advised to follow up with their healthcare provider to assess the success of the graft and to monitor for any signs of venous insufficiency or complications. The expected recovery time can vary based on individual health factors and the extent of the procedure performed.
| Short Descr | CROSS-OVER VEIN GRAFT | Medium Descr | CROSS-OVER VEIN GRAFT VENOUS SYSTEM | Long Descr | Cross-over vein graft to venous system | 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 | 55 - Peripheral vascular bypass |
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) |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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