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An axillary-femoral bypass graft is a surgical procedure designed to redirect blood flow around a section of the aorta and/or iliac artery that has become diseased or obstructed. This procedure is particularly important for patients who may be experiencing reduced blood flow due to vascular issues, which can lead to serious complications if not addressed. The surgery involves creating a bypass using a vein graft, typically harvested from the patient's leg, to establish a new pathway for blood circulation. The procedure begins with a skin incision made just below the clavicle to access the proximal axillary artery, followed by a second incision in the groin area to expose the common femoral artery. A tunnel is then created to connect these two sites, allowing the vein graft to be placed securely. The meticulous dissection and careful handling of the blood vessels are crucial to ensure the success of the graft and to maintain adequate blood flow to the lower extremities. This procedure is often indicated for patients with significant arterial blockages that could lead to ischemia or other serious vascular conditions.
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Indications for performing an axillary-femoral bypass graft include the following conditions:
The axillary-femoral bypass graft procedure involves several critical steps to ensure successful rerouting of blood flow:
Post-procedure care for patients who have undergone an axillary-femoral bypass graft includes monitoring for any signs of complications, such as infection or graft failure. Patients are typically observed for adequate blood flow to the lower extremities, and follow-up Doppler studies may be performed to assess graft patency. Pain management and wound care are also essential components of recovery. Patients may be advised on activity restrictions and rehabilitation to promote healing and improve circulation. Regular follow-up appointments are necessary to monitor the patient's progress and ensure the long-term success of the bypass graft.
| Short Descr | ART BYP GRFT AXILL-FEMORAL | Medium Descr | BYPASS W/VEIN AXILLARY-FEMORAL | Long Descr | Bypass graft, with vein; axillary-femoral | 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 | 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 | 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) |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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) |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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