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An acquired or traumatic arteriovenous fistula is a pathological condition characterized by an abnormal connection between an artery and a vein, which can occur due to trauma or injury to blood vessels. This condition may manifest immediately following the injury or develop gradually over time. The presence of this abnormal communication allows blood to flow from the artery, which operates under high pressure, directly into the vein. Since the walls of veins are not designed to withstand such high-pressure blood flow, they can become distended and enlarged, leading to further complications. Over time, the increased volume of blood flowing into the venous system can result in various cardiovascular issues. The procedure coded as CPT® 35189 involves the surgical repair of this fistula located in the thorax and abdomen. This repair is critical to restore normal blood flow and prevent potential complications associated with the fistula. Additionally, the procedure may involve the use of angiography to visualize the fistula's course, ensuring precise surgical intervention. The surgical steps include isolating the fistula, severing the abnormal connection, and repairing the affected vessels, which may involve sutures or the use of synthetic materials. This comprehensive approach aims to restore vascular integrity and function.
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The procedure coded as CPT® 35189 is indicated for the repair of an acquired or traumatic arteriovenous fistula located in the thorax and abdomen. This condition may arise from various circumstances, including:
The surgical procedure for repairing an acquired or traumatic arteriovenous fistula in the thorax and abdomen involves several critical steps:
Post-procedure care following the repair of an acquired or traumatic arteriovenous fistula includes monitoring for any signs of complications, such as bleeding or infection at the surgical site. Patients may require follow-up imaging to ensure the success of the repair and to assess the patency of the repaired vessels. Additionally, pain management and wound care instructions will be provided to facilitate recovery. The expected recovery period may vary depending on the individual patient's health status and the extent of the surgical intervention.
| Short Descr | RPR ACQ AV FISTULA THRX&ABD | Medium Descr | RPR ACQUIRED/TRAUMATIC AV FISTULA THORAX&ABDOMEN | Long Descr | Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen | 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 |
| 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). | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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