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Thromboendarterectomy is a surgical procedure aimed at removing thrombi, which are blood clots or atherosclerotic plaques, from the walls of arteries. This specific procedure, identified by CPT® Code 35361, focuses on the abdominal aorta and the iliac arteries. The goal of thromboendarterectomy is to restore normal blood flow by excising the occluded material along with the inner layer of the artery, known as the intima. The procedure begins with an incision in the abdomen to access the aorta and iliac arteries. In cases where a more extensive approach is required, such as a combined aortoiliac and femoral thromboendarterectomy, an additional incision is made in the leg to access the femoral artery. During the operation, the affected segments of the blood vessels are carefully isolated and dissected from surrounding tissues. To maintain blood flow during the procedure, a temporary shunt may be placed. The surgical team will then clamp the arteries to control blood flow, allowing for the removal of the thrombus and intima. After the excision, the remaining artery walls are sutured together, and if necessary, a patch graft may be applied to enhance the diameter of the artery. The procedure concludes with the removal of clamps and shunts, followed by a thorough check for bleeding before closing the incision layers. This comprehensive approach is essential for restoring adequate blood circulation and preventing complications associated with arterial occlusion.
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The thromboendarterectomy procedure is indicated for patients experiencing significant arterial occlusion due to thrombus formation or atherosclerotic plaque buildup. The following conditions may warrant this surgical intervention:
The thromboendarterectomy procedure involves several critical steps to ensure the successful removal of occlusive material from the affected arteries. The following outlines the procedural steps:
After the thromboendarterectomy, patients are typically monitored for any signs of complications, such as bleeding or infection. Recovery may involve a hospital stay where vital signs and the surgical site are closely observed. Patients may be advised on activity restrictions and follow-up appointments to assess the success of the procedure and ensure proper healing. Pain management and rehabilitation may also be part of the post-procedure care to facilitate recovery and restore normal function.
| Short Descr | RECHANNELING OF ARTERY | Medium Descr | TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC | Long Descr | Thromboendarterectomy, including patch graft, if performed; combined aortoiliac | 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 | 60 - Embolectomy and endarterectomy of lower limbs |
| 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). | 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). | 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) |
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| 2007-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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