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The procedure described by CPT® Code 35600 involves the harvesting of a segment of an upper extremity artery, typically the radial artery, for use in a coronary artery bypass grafting (CABG) procedure. This surgical intervention is essential for patients who require revascularization of the heart due to significant coronary artery disease. The radial artery is chosen for its suitable size and location, making it an effective conduit for bypassing blocked coronary arteries. The process begins with an incision made in the arm, specifically over the radial artery, which is located just below the crease of the elbow and extends down to the wrist. During the procedure, careful dissection is performed to expose the artery while protecting surrounding structures, including the lateral cutaneous nerve. The muscles of the forearm, namely the brachioradialis and flexor carpi radialis, are retracted to provide a clear view of the artery. Once the radial artery is fully mobilized, it is prepared for grafting by flushing it with a solution of papaverine, which helps to prevent vasospasm. The meticulous nature of this procedure ensures that the harvested artery is suitable for use in the bypass graft, ultimately aiding in restoring adequate blood flow to the heart muscle.
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The harvesting of an upper extremity artery, specifically the radial artery, is indicated for patients undergoing coronary artery bypass grafting (CABG) procedures. This surgical intervention is typically performed in the following scenarios:
The procedure for harvesting the upper extremity artery involves several critical steps to ensure the successful acquisition of the radial artery for grafting:
After the harvesting of the radial artery, post-procedure care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as bleeding or infection at the incision site. Pain management is provided as needed, and patients are advised on how to care for the surgical site. Rehabilitation may be recommended to restore function and strength in the arm. Additionally, the harvested radial artery is prepared for grafting during the subsequent coronary artery bypass procedure, which may occur shortly after the harvesting is completed.
| Short Descr | OPEN HRV UXTR ART 1 SGM CAB | Medium Descr | OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB | Long Descr | Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | 2 | CCS Clinical Classification | 44 - Coronary artery bypass graft (CABG) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 33533 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); single arterial graft | 33534 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts | 33535 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts | 33536 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | 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. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | LT | Left side (used to identify procedures performed on the left side of the body) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2022-01-01 | Changed | Code description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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