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Wiki Unuseable LIMA

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jtb57chevy

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Raceland, KY
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Here's the situation: LIMA was harvested and anastomosed to the LAD, but had poor flow. LIMA was opened and no evidence of disection found, just too small. Bypass to LAD was completed with the SVG (there was also a SVG to the PDA)

So do I bill just for the SVG grafts (33511) or should I bill for the LIMA with a 53 modifier and if so what combination (33533-53 & 33517 or 33533-53 & 33518)? Is there any additional code for opening the LIMA?

Thanks in advance and Happy Friday!
 
I would bill as SVG and forget the LIMA/LD all together. I would not bill with 53 since 53 is typically indicative of medical reason for stopping, and not because the LIMA was too small to graft, IMHO.

CPT suggests use 53 when physician terminates surgical or diagnostic due to extenuating circumstances or those that threaten the well being of the patient.

I would bill only for grafts completed with CABG

HTH
 
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