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Thromboendarterectomy is a surgical procedure specifically targeting the axillary-brachial artery, which is a major blood vessel in the arm. This operation is primarily performed to remove a thrombus, which can be a blood clot or a buildup of atherosclerotic plaque that has adhered to the inner walls of the artery, leading to occlusion or blockage. The procedure involves making an access incision in the arm directly over the affected artery to gain access to the thrombosed area. Once the artery is accessed, the surgeon isolates the affected segment and carefully dissects it away from surrounding structures to prevent damage to adjacent tissues. To maintain blood flow during the procedure, a temporary shunt may be placed. This allows for perfusion while the obstructed portion of the artery is being treated. The surgical process includes placing clamps both proximal and distal to the obstruction, incising the artery, and meticulously removing the plaque and any blood clot debris. The intima, which is the inner lining of the artery, is also removed to enhance the diameter of the artery, facilitating better blood flow. After the removal of the thrombus and intima, the surgeon sutures the edges of the remaining normal intima to the arterial walls. The artery is then repaired, either through primary suturing or by applying a patch graft, which can be either venous or synthetic, to further enlarge the artery's diameter. If a shunt was utilized, it is removed before the vascular clamps are taken off, allowing blood flow to resume through the artery. Finally, the surgical site is checked for hemostasis, and the overlying tissues are closed in layers to ensure proper healing.
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The thromboendarterectomy procedure is indicated for patients presenting with specific conditions affecting the axillary-brachial artery. These indications include:
The thromboendarterectomy procedure involves several critical steps to ensure successful removal of the thrombus and restoration of blood flow. These steps include:
After the thromboendarterectomy procedure, patients typically require monitoring for any signs of complications, such as bleeding or infection. The recovery process may involve pain management and physical therapy to restore function in the arm. Patients are advised to follow up with their healthcare provider to assess the success of the procedure and ensure proper healing. Additionally, lifestyle modifications may be recommended to prevent future vascular issues, including dietary changes and increased physical activity.
| Short Descr | RECHANNELING OF ARTERY | Medium Descr | TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL | Long Descr | Thromboendarterectomy, including patch graft, if performed; axillary-brachial | 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 | Hospital Part B services paid through a comprehensive APC | 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 |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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.) | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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 | 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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| 2017-01-01 | Note | This code inadvertently missing in the 2017 CPT Professional book. It is an active code per CPT errata dated 2016-10-17 and the one dated 2018-08-02 |
| 2007-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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