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Thrombectomy is a surgical procedure aimed at removing a thrombus, or blood clot, from a blood vessel. In the case of CPT® Code 34471, the procedure specifically targets the subclavian vein, which is located beneath the collarbone. The thrombectomy can be performed directly or with the assistance of a catheter, and it involves making an incision in the neck to access the affected area. The formation of a thrombus typically occurs in regions of the vein that are narrowed or stenotic, leading to potential complications such as impaired blood flow. During the procedure, the surgeon makes an incision to expose the vein and gain access to the thrombus. To manage blood flow during the operation, vessel loops are placed both upstream and downstream of the thrombus. The surgeon then incises the vein and removes the thrombus through direct exposure. Alternatively, if a catheter is used, a balloon catheter may be inserted through a venotomy at a location beyond the thrombus. This catheter is advanced past the clot, inflated, and then withdrawn, effectively capturing and removing the thrombus. After the thrombus has been successfully removed, a venography may be conducted to confirm that the entire clot has been eliminated and that the vein is open and functioning properly. It is important to use the correct CPT® code, 34471, for this specific procedure involving the subclavian vein via a neck incision, while 34490 should be used for similar procedures involving the axillary vein through an arm incision.
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The thrombectomy procedure described by CPT® Code 34471 is indicated for the removal of a thrombus located in the subclavian vein. This condition may arise due to various factors, including but not limited to:
The thrombectomy procedure involves several critical steps to ensure the effective removal of the thrombus from the subclavian vein. These steps include:
After the thrombectomy procedure, patients may require monitoring for any complications, such as bleeding or infection at the incision site. Recovery may involve pain management and follow-up imaging studies to ensure the vein remains patent. Patients are typically advised on activity restrictions and signs of potential complications to watch for during the recovery period. The healthcare team will provide specific post-operative care instructions tailored to the individual patient's needs.
| Short Descr | REMOVAL OF VEIN CLOT | Medium Descr | THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC | Long Descr | Thrombectomy, direct or with catheter; subclavian vein, by neck 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 59 - Other OR procedures on vessels of 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. | 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. | 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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