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The procedure described by CPT® Code 35560 refers to a surgical intervention known as aortorenal bypass grafting using a vein. This complex operation is performed to create a new pathway for blood flow from the aorta to the renal artery, which may be obstructed due to various conditions. The surgery begins with an incision in the upper abdomen, allowing access to the abdominal aorta and the renal artery. The lesser omentum, a fold of peritoneum, is opened to facilitate the dissection of the diaphragmatic crura, which are the muscular structures that support the diaphragm. Once the upper abdominal aorta is exposed, the renal artery is carefully dissected free from surrounding tissues to prepare for the grafting procedure. A vein graft, often harvested from the saphenous vein in the leg, is utilized to bypass the obstructed segment of the renal artery. The harvesting process involves making an incision over the saphenous vein, dissecting the soft tissue away, and ligating any branches before removing the vein segment. The surgical team then places a side-biting clamp on the aorta at the base of the renal artery to control blood flow during the grafting. An incision is made in the aorta, and the harvested vein graft is sutured to it. Subsequently, the renal artery is incised beyond the area of obstruction, and the vein graft is sutured to the renal artery, restoring blood flow. The procedure concludes with the release of the vascular clamp and a thorough check of the suture lines to ensure there is no bleeding, thereby promoting hemostasis.
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The aortorenal bypass grafting procedure, as described by CPT® Code 35560, is indicated for patients experiencing significant renal artery obstruction or disease that impairs blood flow to the kidneys. This condition may lead to hypertension, renal ischemia, or renal failure. The procedure is typically performed when less invasive treatments have failed or are not appropriate, and it aims to restore adequate blood supply to the renal artery to improve kidney function and overall health.
The aortorenal bypass grafting procedure involves several critical steps to ensure successful grafting and restoration of blood flow. The first step is to make an incision in the upper abdomen, which allows the surgeon to access the abdominal aorta and renal artery. Following this, the lesser omentum is opened, providing further access to the surgical site. The next step involves the sharp dissection of the diaphragmatic crura, which are the muscular structures that support the diaphragm, to expose the upper abdominal aorta adequately.
After the aortorenal bypass grafting procedure, patients are typically monitored in a recovery area for any immediate complications. Post-operative care may include pain management, monitoring vital signs, and ensuring proper blood flow to the kidneys. Patients may be advised to follow specific guidelines regarding activity levels and wound care to promote healing. Follow-up appointments are essential to assess the success of the graft and monitor kidney function, as well as to manage any potential complications that may arise post-surgery.
| Short Descr | ART BYP GRFT AORTORENAL | Medium Descr | BYPASS W/VEIN AORTORENAL | Long Descr | Bypass graft, with vein; aortorenal | 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). | 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. | 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 | 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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