CABG Arterial or Venous Graft??

R1CPC

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My physician harvested ther radial artery and attached it to the hood of the saphenous vein graft to the ramus. What would this be considered arterial or venous graft????
 

Michelle Thompson

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Ok I will give this a try. I believe this would be a Venous Graft. In the CPT Note: To determine the number of bypass grafts in a coronary artery bypass (CABG), count the number of distal anastomoses (contact points) where the bypass graft artery or vein is sutured to the diseased coronary artery(s). I would use modifier 22, or at least modifier 59-because you should bill for the 35600 Harvest of Upper Extremity Artery.
 

R1CPC

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so if for instance he attached the IMA to LAD and the ramus was attached like the example above, RCA anastamosed to the saphenous vein we would code
35333
33518-22 ( this would include the radial artery attached to the saphenous vein)
35600
 

Michelle Thompson

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Yes,
33533 IMA to LAD
33518-22 is - (1st)the Saphenous Vein Graft to the Ramus (this does include the Radial Artery attached to the hood of the Saphenous Vein) and
(2nd) Saphenous Vein Graft to the RCA.
35600 Harvest of Upper Extremity Artery
 
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