© Copyright 2025 American Medical Association. All rights reserved.
A brachial-brachial bypass graft is a surgical procedure designed to create an alternative pathway for blood flow around a diseased or obstructed segment of the brachial artery, which is located in the upper arm. This procedure is performed on the same side of the body where the obstruction occurs, ensuring that blood can continue to flow effectively to the arm and hand. The process begins with the surgeon making a skin incision over the proximal (closer to the center of the body) portion of the brachial artery, followed by a second incision over the distal (further from the center) section of the artery. This allows the surgeon to access the artery directly and create a tunnel between the two incision sites. To facilitate the bypass, a vein graft is harvested, typically from the saphenous vein in the leg. The harvesting involves making an incision in the leg, dissecting the soft tissue away from the vein, and carefully ligating and dividing its branches. The selected segment of the vein is then ligated at both ends, cut, and removed for use in the graft. Once the vein graft is prepared, vascular clamps are applied to the proximal brachial artery to control blood flow, and an incision is made in the artery. The vein graft is then sutured to the proximal end of the brachial artery and passed through the tunnel created earlier. The distal brachial artery is similarly clamped and incised, allowing the other end of the vein graft to be sutured in place. After the clamps are removed, the surgeon checks for proper blood flow through the graft using Doppler ultrasound and evaluates distal pulses to confirm the bypass graft's patency, ensuring that blood is flowing correctly to the arm and hand.
© Copyright 2025 Coding Ahead. All rights reserved.
The brachial-brachial bypass graft procedure is indicated for patients experiencing conditions that lead to obstruction or disease of the brachial artery. These conditions may include:
The brachial-brachial bypass graft procedure involves several critical steps to ensure successful grafting and restoration of blood flow. The procedure begins with the patient positioned appropriately, and anesthesia administered to ensure comfort during the surgery.
Following the brachial-brachial bypass graft procedure, patients are typically monitored in a recovery area to ensure stable vital signs and proper blood flow. Post-operative care may include pain management, monitoring for signs of infection at the incision sites, and ensuring that the graft remains patent. Patients may be advised on activity restrictions and follow-up appointments to assess the success of the graft and overall recovery. Rehabilitation may be necessary to restore function and strength in the affected arm.
| Short Descr | ART BYP GRFT BRACHIAL-BRCHL | Medium Descr | BYPASS W/VEIN BRACHIAL-BRACHIAL | Long Descr | Bypass graft, with vein; brachial-brachial | 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) | P1G - Major procedure - 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) |
| 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). | 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. | 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2013-01-01 | Changed | Short Descriptor changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
Get instant expert-level medical coding assistance.