© Copyright 2025 American Medical Association. All rights reserved.
A direct repair of a blood vessel in the upper extremity, specifically in the hand or finger, involves a surgical procedure aimed at restoring the integrity of the damaged blood vessel. This procedure is necessary when a blood vessel has been compromised due to injury, which can lead to significant bleeding and impaired blood flow. The approach taken during the repair is contingent upon the specific blood vessel that has sustained damage. Initially, the surgeon exposes the injured vessel and applies clamps both proximal and distal to the site of injury. This clamping is crucial as it helps control bleeding during the repair process. In some cases, to maintain blood flow to the area while the repair is being conducted, a temporary shunt may be placed. Once the vessel is adequately exposed, the extent of the injury is carefully assessed. The next step involves debriding the edges of the injured vessel to remove any damaged tissue, followed by reapproximating the vessel edges in an end-to-end manner using sutures. After the suturing is completed, the clamps are released, and hemostasis is meticulously checked along the suture line to ensure that there is no further bleeding. Finally, the overlying tissues are repaired in layers with sutures to restore the anatomical structure of the hand or finger.
© Copyright 2025 Coding Ahead. All rights reserved.
The direct repair of a blood vessel in the hand or finger is indicated in the following situations:
The procedure for the direct repair of a blood vessel in the hand or finger involves several critical steps:
Post-procedure care following the direct repair of a blood vessel in the hand or finger typically includes monitoring for signs of infection, ensuring proper healing of the surgical site, and assessing blood flow to the area. Patients may be advised to keep the affected area elevated and to follow specific wound care instructions provided by the healthcare provider. Follow-up appointments are essential to evaluate the success of the repair and to address any complications that may arise during the recovery process.
| Short Descr | RPR BLD VSL DIR HAND FINGER | Medium Descr | REPAIR BLOOD VESSEL DIRECT HAND FINGER | Long Descr | Repair blood vessel, direct; hand, finger | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 3 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
| 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). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.