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A bypass graft is a surgical procedure designed to create an alternative pathway for blood flow around a diseased or obstructed segment of the lower aorta, specifically to one or both iliac arteries. In this procedure, a graft made from materials other than the patient's own veins is utilized. The choice of synthetic grafts is often preferred due to their ability to accommodate the larger diameters of the aorta and iliac arteries, which can enhance blood flow and reduce the risk of complications associated with using natural vein material. The procedure typically involves making an incision in the lower abdomen to access the aorta. Once the aorta is exposed, clamps are applied above the area of obstruction to control blood flow. The surgeon may tie off the aorta above the diseased section, after which one end of the graft is securely sutured to the aorta. Following this, the clamp is released to check for any leaks at the anastomosis site. The iliac artery is then clamped distal to the graft site, and through a separate incision, the other end of the graft is sutured into the iliac artery. The graft connection is again assessed for leaks and patency before the abdominal incision is closed. This surgical intervention effectively reroutes blood flow, bypassing the obstructed area of the aorta, thereby improving circulation to the lower extremities.
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The bypass graft procedure is indicated for patients experiencing significant vascular obstruction or disease affecting the lower aorta and iliac arteries. The following conditions may warrant this surgical intervention:
The bypass graft procedure involves several critical steps to ensure successful revascularization of the affected area. The following outlines the procedural steps:
Post-procedure care is essential for ensuring proper recovery and monitoring for complications. Patients are typically observed for any signs of bleeding or infection at the surgical site. Follow-up imaging may be required to assess the patency of the graft and ensure that blood flow is restored effectively. Patients may also be advised on lifestyle modifications and prescribed medications to manage underlying conditions such as hypertension or hyperlipidemia. The expected recovery period can vary, but patients are generally encouraged to gradually resume normal activities while adhering to their healthcare provider's recommendations.
| Short Descr | ART BYP AORTOILIAC | Medium Descr | BYP OTH/THN VEIN AORTOILIAC | Long Descr | Bypass graft, with other than vein; aortoiliac | 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) | 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 | 1 | CCS Clinical Classification | 55 - Peripheral vascular bypass |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |