Cardiology Coding Alert

Question: I was looking through my CPT^® 2021 coding manual and noticed some additional guidelines for the arterial grafting for coronary artery bypass codes 33533-33548. Could you please help me understand those?

Alabama Subscriber

Answer: Although you didn’t gain any new options in the 33533 (Coronary artery bypass, using arterial graft(s); single arterial graft)-33548 (Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, Dor procedures)) code set for 2021, CPT^® did add some new clarification about how to report these codes.

For example, since the procurement of the artery grafting in included in the work for codes 33533-33536, your cardiologist cannot report this procurement as a separate service or co-surgery.

However, there is an exception when your cardiologist procures an upper extremity artery, such as the radial artery, according to CPT^®. If your cardiologist does harvest an upper extremity artery, you can report add-on code +35600 (Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure (List separately in addition to code for primary procedure)) in addition to the bypass procedure.

On the other hand, if your cardiologist harvested an upper extremity vein, you would report add-on code +35500 (Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure)) in addition to the bypass procedure.

Also, if your cardiologist harvested a femoropopliteal vein segment, you should report add-on code +35572 (Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure)) in addition to the bypass procedure.

Don’t miss: If a surgical assistant performs the arterial and/ or venous graft procurement, you should append modifier 80 (Assistant surgeon) to codes +33517 (Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure))- +33523 (… or more venous grafts (List separately in addition to code for primary procedure)) and 33533-33536, as appropriate.