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Official Description

Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Thrombectomy is a surgical procedure aimed at the removal of a thrombus, which is a blood clot that obstructs blood flow within a vein. This specific procedure, identified by CPT® Code 34401, involves the vena cava or iliac vein and is performed through an abdominal incision. The thrombus typically forms in areas where the vein is narrowed or stenotic, leading to potential complications such as swelling, pain, or even more severe vascular issues. During the thrombectomy, an incision is made in the abdomen to access the affected vein directly. In some cases, a catheter may be utilized to assist in the removal of the thrombus, allowing for a less invasive approach. The procedure may also involve the placement of vessel loops to control blood flow, ensuring that the surgical site is adequately managed during the thrombus removal process. Following the extraction of the clot, a venography may be conducted to confirm that the vein is clear and that normal blood flow has been restored. This procedure is critical for patients experiencing significant vascular obstruction due to thrombus formation, and it is essential for medical coders and billers to accurately document the specifics of the procedure for proper reimbursement and compliance.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Thrombectomy is indicated for patients presenting with a thrombus in the vena cava or iliac vein, particularly when symptoms of venous obstruction are evident. The following conditions may warrant the performance of this procedure:

  • Vena Cava Thrombosis - The presence of a thrombus in the vena cava can lead to significant complications, including swelling and pain in the lower extremities.
  • Iliac Vein Thrombosis - A thrombus in the iliac vein can obstruct blood flow, resulting in similar symptoms and potential long-term vascular issues.
  • Severe Venous Stenosis - Patients with narrowed veins may develop thrombi that require surgical intervention to restore normal blood flow.

2. Procedure

The thrombectomy procedure involves several critical steps to ensure the effective removal of the thrombus. The following procedural steps are outlined:

  • Step 1: Incision - An abdominal incision is made to access the vena cava or iliac vein. This incision allows the surgeon to directly visualize and access the thrombus for removal.
  • Step 2: Vessel Control - Vessel loops are placed both proximal and distal to the thrombus. This step is crucial as it helps to control blood flow during the procedure, minimizing the risk of excessive bleeding.
  • Step 3: Vein Incision - The affected vein is incised to expose the thrombus. This direct approach allows for the precise removal of the clot.
  • Step 4: Thrombus Removal - The thrombus is removed through direct exposure. In some cases, a catheter may be used for remote removal, where a balloon catheter is inserted through a venotomy at a site beyond the thrombus, inflated, and then withdrawn to capture and remove the clot.
  • Step 5: Venography - After the thrombus has been removed, a venography may be performed to ensure that the entire clot has been successfully extracted and that the vein is patent, confirming the restoration of normal blood flow.

3. Post-Procedure

Post-procedure care following a thrombectomy includes monitoring the patient for any signs of complications, such as bleeding or infection at the incision site. Patients may also require follow-up imaging studies to assess the success of the procedure and ensure that the vein remains patent. Pain management and instructions for activity restrictions may be provided to facilitate recovery. It is essential for healthcare providers to educate patients on signs of potential complications and the importance of follow-up appointments to monitor their vascular health.

Short Descr REMOVAL OF VEIN CLOT
Medium Descr THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC
Long Descr Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision
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 61 - Other OR procedures on vessels other than head and neck
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).
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).
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).
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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Pre-1990 Added Code added.
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