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The procedure described by CPT® Code 35475 refers to transluminal balloon angioplasty performed percutaneously on the brachiocephalic trunk or its branches, with each vessel treated being billed separately. This minimally invasive technique is utilized to open narrowed or blocked arteries, specifically targeting the brachiocephalic artery, which is a major vessel supplying blood to the right arm and head. The process begins with the preparation of the skin over the access artery, typically the brachiocephalic artery, followed by puncturing the artery with a needle to insert a sheath. A guidewire is then navigated through the access point into the occluded area of the artery. A catheter equipped with a balloon tip is advanced over this guidewire to the site of the blockage. Once positioned, the balloon is inflated, compressing the plaque against the arterial wall to restore blood flow. This inflation may be repeated multiple times to achieve optimal results. After the angioplasty, the catheter is exchanged for a guidewire, and an angiography catheter is introduced to assess the success of the procedure through completion angiography, ensuring the artery is patent. Finally, the angiography catheter is removed, and pressure is applied to the puncture site to prevent bleeding, followed by the application of a pressure dressing. This comprehensive approach allows for effective treatment of arterial blockages in the brachiocephalic trunk or branches.
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The procedure is indicated for patients presenting with conditions that result in stenosis or occlusion of the brachiocephalic trunk or its branches. These conditions may include:
The procedure involves several critical steps to ensure successful angioplasty of the brachiocephalic trunk or branches. Each step is essential for achieving the desired outcome of restoring blood flow.
Post-procedure care involves monitoring the patient for any signs of complications, such as bleeding or hematoma at the puncture site. The patient may be advised to rest and avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to assess the success of the procedure and ensure the continued patency of the treated artery. Additionally, patients may be instructed on signs and symptoms to watch for that could indicate complications, such as increased pain or swelling in the affected area.
| Short Descr | REPAIR ARTERIAL BLOCKAGE | Medium Descr | TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA | Long Descr | Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel | Status Code | Restricted Coverage | Global Days | 000 - Endoscopic or Minor Procedure | 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 | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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 | Not applicable/unspecified. | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
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