© Copyright 2025 American Medical Association. All rights reserved.
An axillary-axillary bypass graft is a surgical procedure designed to create a new pathway for blood flow around a diseased or obstructed segment of the axillary artery, which is located in the upper arm region. This procedure is particularly indicated for patients who have significant arterial disease affecting the contralateral axillary artery, meaning the artery on the opposite side of the body. The surgery begins with a skin incision made just below the clavicle, allowing access to the underlying soft tissues. Surgeons then carefully dissect through these tissues to expose the proximal end of the first axillary artery. This process is mirrored on the opposite side to expose the second axillary artery. Once both arteries are accessible, a tunnel is created across the chest, connecting the two axillary arteries. A synthetic graft, which is a tubular structure made from biocompatible materials, is selected based on the required size for optimal fit and blood flow. The procedure involves applying vascular clamps to the first axillary artery to control blood flow, followed by an incision to prepare the artery for grafting. The synthetic graft is then sutured to the first axillary artery, and it is passed through the tunnel created earlier. The same steps are repeated for the second axillary artery, where it is clamped, incised, and sutured to the other end of the graft. After the graft is securely in place, the vascular clamps are removed, and the surgeon checks for proper blood flow through the graft using Doppler ultrasound, while also evaluating distal pulses to confirm the patency and functionality of the bypass graft.
© Copyright 2025 Coding Ahead. All rights reserved.
The axillary-axillary bypass graft procedure is indicated for patients experiencing significant arterial disease or obstruction affecting the axillary arteries. This condition may manifest as symptoms such as claudication, which is pain or cramping in the arms during physical activity, or other signs of compromised blood flow. The procedure is specifically performed to restore adequate blood circulation to the upper extremities when the contralateral axillary artery is affected.
The axillary-axillary bypass graft procedure involves several critical steps to ensure successful grafting and restoration of blood flow. Initially, a skin incision is made just below the clavicle on one side of the chest. This incision allows the surgeon to access the underlying soft tissues and the first axillary artery. The surgeon carefully dissects through the soft tissue to expose the proximal aspect of the first axillary artery, ensuring that the artery is adequately visualized for the grafting process.
After the axillary-axillary bypass graft procedure, patients are typically monitored for any signs of complications, such as bleeding or infection at the incision sites. It is essential to assess the patency of the graft and ensure that blood flow is adequate to the upper extremities. Patients may be advised to follow specific post-operative care instructions, including activity restrictions and wound care. Follow-up appointments are crucial for evaluating the success of the graft and monitoring the patient's recovery progress. The expected recovery period may vary based on individual health factors and the extent of the procedure.
| Short Descr | ART BYP AXILLARY-AXILLARY | Medium Descr | BYP OTH/THN VEIN AXILLARY-AXILLARY | Long Descr | Bypass graft, with other than vein; axillary-axillary | 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 |
| 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. | 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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. |