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Transection of the pulmonary artery is a surgical procedure primarily performed in newborns who present with specific cardiac and great vessel anomalies. This intervention serves as a palliative measure, providing temporary relief until a more comprehensive surgical repair can be executed. The procedure is indicated when there exists an alternative vascular connection to the lungs, which facilitates the flow of deoxygenated blood into the lungs, allowing for the return of oxygenated blood back to the heart. The surgical approach involves making an incision in the chest to gain access to the heart and the pulmonary artery. Following this, cardiopulmonary bypass is initiated to maintain circulation and oxygenation during the procedure. The main pulmonary artery, also referred to as the trunk, is clamped both above and below the designated incision site, allowing for the transection of the artery. After the transection, the distal and proximal stumps of the pulmonary artery are meticulously repaired using sutures. Finally, chest tubes are inserted to facilitate drainage, and the chest incision is subsequently closed to complete the procedure.
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The transection of the pulmonary artery is indicated for newborns with specific cardiac and great vessel anomalies. This procedure is performed as a palliative measure to manage conditions that may require immediate intervention while awaiting more extensive surgical repairs. The following are the explicit indications for this procedure:
The procedure of transection of the pulmonary artery involves several critical steps that ensure the safety and effectiveness of the intervention. Each step is performed with precision to achieve the desired outcome.
Post-procedure care following the transection of the pulmonary artery involves monitoring the patient for any complications and ensuring proper recovery. Patients are typically observed in a critical care setting where vital signs, oxygenation levels, and overall stability can be closely monitored. The presence of chest tubes allows for the drainage of any excess fluid, which is essential for preventing respiratory complications. The healthcare team will also assess the surgical site for signs of infection or other issues. Recovery may vary depending on the individual patient's condition and the complexity of the anomalies being addressed. Follow-up care will include evaluations to determine the need for further surgical interventions or additional treatments as the patient grows and develops.
| Short Descr | TRANSECT PULMONARY ARTERY | Medium Descr | TRANSECTION PULMONARY ARTERY W/CARD BYPASS | Long Descr | Transection of pulmonary artery with cardiopulmonary bypass | 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 | 61 - Other OR procedures on vessels other than head and neck |
This is a primary code that can be used with these additional add-on codes.
| 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33259 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure) | 33924 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure) | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure) |
| 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). | 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 | CR | Catastrophe/disaster related | 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) |
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| 1994-01-01 | Added | First appearance in code book in 1994. |
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