2025 CPT code 33891
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), bilateral procedures (50), or distinct procedural services (59), among others.
Medical necessity must be established for both the endovascular repair of the descending thoracic aorta and the carotid-carotid bypass. This should include evidence of significant arterial disease requiring intervention.
In simple words: This procedure creates a new pathway for blood flow between the carotid arteries in the neck. It's done during a minimally invasive repair of the aorta in the chest, using a small incision in the neck. This new pathway helps blood flow around a blockage or damaged part of the artery in the neck.
This code describes a procedure where a bypass graft (not using a vein) is created between the carotid arteries, passing behind the pharynx, through a neck incision. This is performed alongside an endovascular repair of the descending thoracic aorta.The procedure involves making incisions on both sides of the neck to access the carotid arteries. A tunnel is created behind the pharynx, and a graft is placed, connecting the two carotid arteries. This bypasses the damaged or blocked section of the artery.
Example 1: A patient with a descending thoracic aortic aneurysm and a significant stenosis in the left carotid artery undergoes endovascular repair of the aneurysm.To ensure adequate cerebral blood flow during the procedure, a carotid-carotid bypass is performed using a retropharyngeal approach through a neck incision (33891)., A patient presents with a descending thoracic aortic dissection and a severely narrowed right carotid artery.Endovascular repair is planned for the dissection, and a transcervical retropharyngeal carotid-carotid bypass is performed (33891) concurrently to maintain blood supply to the brain., A patient requires endovascular repair of their descending thoracic aorta. During preoperative assessment, a critical blockage in the left common carotid artery is discovered. To mitigate the risk of stroke during the aortic repair, a bypass using a synthetic graft is created between the carotid arteries, bypassing the blocked segment (33891).
Documentation should include the diagnosis necessitating the procedure, the type of graft used, details of the endovascular repair of the descending thoracic aorta, operative details of the carotid-carotid bypass, and any intraoperative complications.
** This code describes a complex procedure performed in conjunction with endovascular repair. Proper documentation and coding are crucial for accurate reimbursement. Please note this information is current as of today's date, December 1st, 2024, and may be subject to change with updates to coding guidelines.
- Specialties:Cardiothoracic Surgery, Vascular Surgery
- Place of Service:Inpatient Hospital