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Thromboendarterectomy is a surgical procedure aimed at removing thrombi, which are blood clots or atherosclerotic plaques, from occluded arteries. Specifically, CPT® Code 35363 refers to a combined aortoiliofemoral thromboendarterectomy, which involves the abdominal aorta, iliac artery, and femoral artery. This procedure is essential for restoring blood flow in patients with significant arterial blockages that can lead to severe complications, including ischemia or limb loss. The process begins with an incision in the abdomen to access the aorta and iliac arteries, and if necessary, an additional incision in the leg to access the femoral artery. The surgeon isolates the affected segments of the blood vessels, carefully dissects them from surrounding tissues, and removes the obstructive material along with the inner lining of the artery (intima) to enhance the vessel's diameter. This meticulous approach not only alleviates the blockage but also aims to restore normal blood flow, thereby improving the patient's overall vascular health. The procedure may involve the use of temporary shunts to maintain perfusion during surgery and may conclude with the application of sutures or grafts to repair the arteries, ensuring that blood flow is reestablished effectively.
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The thromboendarterectomy procedure, specifically CPT® Code 35363, is indicated for patients presenting with significant arterial occlusions that may lead to critical ischemia or other vascular complications. The following conditions may warrant this surgical intervention:
The thromboendarterectomy procedure involves several critical steps to ensure the effective removal of occlusions and restoration of blood flow. The following outlines the procedural steps involved:
After the thromboendarterectomy procedure, patients are typically monitored for any signs of complications, such as bleeding or infection. Recovery may involve a hospital stay where vital signs are closely observed, and pain management is provided. Patients may be advised on activity restrictions and follow-up appointments to assess the success of the procedure and monitor for any recurrence of symptoms. Rehabilitation may also be recommended to improve circulation and overall vascular health. It is essential for patients to adhere to prescribed medications and lifestyle modifications to support recovery and prevent future vascular issues.
| Short Descr | RECHANNELING OF ARTERY | Medium Descr | TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL | Long Descr | Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral | 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 |
| 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). | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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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