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The CPT® Code 35500 refers to the surgical procedure involving the harvest of a segment of upper extremity vein, specifically for use in lower extremity or coronary artery bypass procedures. This procedure is essential when a suitable vein is required to create a bypass around blocked arteries, facilitating improved blood flow. The upper extremity veins, such as the brachial and basilic veins, are commonly selected due to their size and accessibility. During the procedure, a deep incision is made on the medial side of the upper arm to expose the chosen vein. The surrounding soft tissue is carefully dissected away from the vein, and any branches of the vein are ligated and divided to ensure a clean segment for harvesting. Once the appropriate length of vein is identified, it is ligated at both the proximal and distal ends, cut, and then removed from the arm. After the vein is harvested, the incision in the arm is closed, and the vein is prepared for its intended use in the bypass grafting procedure. This meticulous process is crucial for ensuring that the harvested vein segment is viable and suitable for effective grafting, ultimately contributing to the success of the bypass surgery.
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The procedure described by CPT® Code 35500 is indicated for patients requiring a bypass procedure due to compromised blood flow in the lower extremities or coronary arteries. The following conditions may warrant the harvesting of an upper extremity vein segment:
The harvesting of an upper extremity vein for bypass procedures involves several critical steps to ensure the vein is suitable for grafting. The procedure begins with the patient positioned appropriately to allow access to the upper arm. A deep incision is made on the medial aspect of the upper arm, providing direct access to the underlying veins. Once the incision is made, the surgeon carefully dissects the soft tissue surrounding the chosen vein, which is typically the brachial or basilic vein. This dissection is performed meticulously to avoid damaging the vein or surrounding structures.
After the harvesting of the upper extremity vein, post-procedure care is essential to ensure proper healing and minimize complications. The patient is typically monitored for any signs of infection or complications at the incision site. Pain management may be provided as needed, and the patient may be advised to keep the arm elevated to reduce swelling. Follow-up appointments are crucial to assess the healing process of the incision and the viability of the harvested vein. Additionally, the patient may receive instructions on activity restrictions to promote optimal recovery and prevent strain on the surgical site.
| Short Descr | HARVEST VEIN FOR BYPASS | Medium Descr | HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX | Long Descr | Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (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) | 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 33510 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; single coronary venous graft | 33511 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 2 coronary venous grafts | 33512 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 3 coronary venous grafts | 33513 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 4 coronary venous grafts | 33514 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, vein only; 5 coronary venous grafts | 33516 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 6 or more coronary venous grafts | 33517 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure) | 33518 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure) | 33519 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (List separately in addition to code for primary procedure) | 33521 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure) | 33522 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure) | 33523 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (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) | 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 | 35556 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; femoral-popliteal | 35566 | MPFS Status: Active Code APC C CPT Assistant Article Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels | 35570 | MPFS Status: Active Code APC C Illustration for Code Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial | 35571 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels | 35583 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-popliteal | 35585 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery | 35587 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; popliteal-tibial, peroneal |
| 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. | 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.) | 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). | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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