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An axillary-femoral-femoral bypass graft is a surgical procedure designed to reroute blood flow around a diseased or obstructed segment of the aorta and/or iliac arteries. This procedure is particularly important in cases where blood flow is compromised due to vascular disease, which can lead to significant complications if not addressed. The term "bypass graft" refers to the use of a vein graft to create a new pathway for blood to travel, effectively bypassing the obstructed area. The procedure involves making incisions in both the chest and groin to access the axillary and femoral arteries, respectively. The surgical team meticulously dissects soft tissue to expose these arteries, allowing for the creation of tunnels through which the vein graft will be placed. The harvesting of the vein graft, often from the saphenous vein in the leg, is a critical step, as it provides the necessary conduit for the bypass. The successful completion of this procedure is assessed by checking blood flow through the graft and evaluating distal pulses to ensure that the bypass is functioning properly and that blood is being delivered effectively to the lower extremities.
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The axillary-femoral-femoral bypass graft procedure is indicated for patients experiencing significant vascular obstruction or disease that impairs blood flow to the lower extremities. The following conditions may warrant this surgical intervention:
The axillary-femoral-femoral bypass graft procedure involves several critical steps to ensure successful rerouting of blood flow:
Post-procedure care for patients undergoing an axillary-femoral-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 healthcare providers will assess distal pulses regularly. Pain management and wound care are also essential components of post-operative care. Patients may be advised on activity restrictions and rehabilitation to promote recovery and ensure the success of the graft.
| Short Descr | ART BYP GRFT AXILL/FEM/FEM | Medium Descr | BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL | Long Descr | Bypass graft, with vein; axillary-femoral-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) |
| 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). | 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). | 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) |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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