I'm not sure if I am understanding the question or not but here is my answer . If the coronary artery is so heavily diseased that the surgeon cannot find a site to bypass, then he will need to clean it out before bypassing it. The surgeon would describe opening up the vessel (more so than what is usually opened for the bypass alone) and would document removing the excessive plaque from the artery. When done removing the plaque, he would sew the bypass graft to the artery. Remember, you can only charge for performing an endarterectomy on the LAD, circumflex or RCA. All others are included in the CABG. Also remember that CPT 33572 is an add-on code.
Hope that helps.
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