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An aortoceliac or aortomesenteric bypass graft is a surgical procedure that involves the creation of a bypass using a vein to circumvent a diseased or obstructed segment of the celiac or mesenteric artery. The celiac artery, also known as the celiac trunk, is the first major branch of the aorta that emerges just below the diaphragm. It branches into three significant arteries: the hepatic artery, which supplies blood to the liver; the left gastric artery, which provides blood to the stomach; and the splenic artery, which supplies the spleen, pancreas, and parts of the stomach. Additionally, there are two mesenteric arteries: the superior mesenteric artery, which is responsible for delivering blood to the small intestine and the upper part of the large intestine, and the inferior mesenteric artery, which supplies blood to the lower part of the large intestine and the rectum. When either the celiac trunk or the superior mesenteric artery becomes obstructed or diseased, it can lead to significant complications, necessitating surgical intervention. The procedure typically involves an incision in the upper abdomen to access the affected arteries, allowing for the careful dissection and exposure of the celiac artery and its branches or the superior mesenteric artery. In cases where the inferior mesenteric artery is also involved, a separate incision in the lower abdomen may be required to facilitate access. The surgical team will harvest a vein graft, often from the saphenous vein in the leg, to create the bypass. This vein graft is then meticulously sutured to the aorta and the affected artery, restoring blood flow and alleviating the obstruction.
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The aortoceliac or aortomesenteric bypass graft procedure is indicated for patients experiencing significant arterial obstruction or disease affecting the celiac trunk or mesenteric arteries. The following conditions may warrant this surgical intervention:
The procedure for aortoceliac or aortomesenteric bypass grafting involves several critical steps to ensure successful grafting and restoration of blood flow. The following outlines the procedural steps:
Post-procedure care for patients undergoing an aortoceliac or aortomesenteric bypass graft typically involves monitoring for complications such as bleeding, infection, or graft failure. Patients may require a hospital stay for observation and management of pain. Recovery may involve gradual resumption of normal activities, with specific instructions provided by the healthcare team regarding diet and physical activity. Follow-up appointments are essential to assess the success of the graft and ensure proper healing.
| Short Descr | ART BYP GRFT AORCEL/AORMESEN | Medium Descr | BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC | Long Descr | Bypass graft, with vein; aortoceliac or aortomesenteric | 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 | 56 - Other vascular bypass and shunt, not heart |
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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | 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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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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