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The procedure described by CPT® Code 37700 involves the surgical ligation and division of the long saphenous vein, which is a major vein located in the leg. This procedure is specifically performed at the saphenofemoral junction, where the long saphenous vein meets the femoral vein, or at a point distal to this junction. The term 'ligation' refers to the process of tying off the vein to prevent blood flow, while 'division' indicates the cutting of the vein. The procedure typically begins with an incision made in the groin crease to access the long saphenous vein and its tributaries, which are smaller veins that drain into the long saphenous vein. Once exposed, these tributaries are carefully dissected and ligated with sutures to ensure they do not bleed. The surgeon then exposes the saphenofemoral junction, ligates the long saphenous vein, and divides it flush with the femoral vein. In cases where the interruption occurs distal to the saphenofemoral junction, a separate incision is made in the thigh over the vein, allowing for similar exposure, dissection, ligation, and division of the long saphenous vein. This procedure is often indicated for various venous conditions, including varicose veins, and is crucial for managing venous insufficiency and improving venous circulation in the lower extremities.
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The ligation and division of the long saphenous vein at the saphenofemoral junction or at distal interruptions is typically indicated for the following conditions:
The procedure for ligation and division of the long saphenous vein involves several key steps:
After the ligation and division of the long saphenous vein, patients may require specific post-procedure care to ensure proper healing and recovery. This may include monitoring for any signs of complications such as bleeding or infection at the incision site. Patients are often advised to rest and elevate the affected leg to reduce swelling. Compression stockings may be recommended to support venous return and minimize discomfort. Follow-up appointments are typically scheduled to assess the healing process and to address any concerns that may arise during recovery. The expected recovery time can vary based on individual patient factors and the extent of the procedure performed.
| Short Descr | LIGATION&DIV LONG SAPH VEIN | Medium Descr | LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ | Long Descr | Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions | 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) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 53 - Varicose vein stripping, lower limb |
| 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). | 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. | 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.) | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | 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) | SG | Ambulatory surgical center (asc) facility service | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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