How To Use CPT Code 33891

CPT 33891 describes the procedure of bypass graft with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33891?

CPT 33891 is used to describe a specific surgical procedure that involves bypass grafting with a non-vein graft. The procedure is performed in conjunction with endovascular repair of the descending thoracic aorta. The bypass graft is created by making an incision in the neck and using soft tissues behind the pharynx. This code is used when the procedure is performed to bypass a problem area in the carotid artery.

2. Official Description

The official description of CPT code 33891 is: ‘Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision.’

3. Procedure

1. The provider begins by making incisions on both sides of the neck to access the common carotid arteries.
2. The common carotid arteries are isolated and dissected from surrounding structures.
3. A tunnel is created behind the pharynx, and a tube is placed in the tunnel.
4. One end of the tube is attached to an opening in one carotid artery, and the other end is attached to an opening in the other carotid artery.
5. Alternatively, the provider may clamp the vessel on either side of the problem area in the carotid artery and incise the artery above the damage or blockage.
6. A synthetic vein graft is sutured to the open end of the carotid artery, bypassing the problem area.
7. The graft is then sutured to the side of the artery on the other side of the neck.
8. Once the procedure is complete, the incisions in the neck are closed with sutures.

4. Qualifying circumstances

CPT 33891 is performed in specific circumstances where bypass grafting with a non-vein graft is necessary to address a problem area in the carotid artery. This procedure is performed in conjunction with endovascular repair of the descending thoracic aorta. It is important to note that CPT 33891 should not be reported in conjunction with codes 35509 and 35601.

5. When to use CPT code 33891

CPT code 33891 should be used when the provider performs a bypass graft with a non-vein graft in conjunction with endovascular repair of the descending thoracic aorta. This code should not be used if the procedure involves codes 35509 or 35601.

6. Documentation requirements

To support a claim for CPT 33891, the provider must document the following information:

• Reason for the procedure and the need for bypass grafting
• Details of the specific procedure performed, including the incisions made and the use of a non-vein graft
• Date of the procedure and the duration of the surgery
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33891, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should be performed in conjunction with endovascular repair of the descending thoracic aorta and involve bypass grafting with a non-vein graft. It should not be reported with codes 35509 or 35601. Additional tips for accurate billing may include reporting anesthesia services separately if applicable and selecting the most appropriate code from the range 33880-33891 for endovascular repair procedures of the descending thoracic aorta.

8. Historical information

CPT 33891 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition. It is important to stay updated with any changes or revisions to ensure accurate coding and billing.

9. Examples

1. A patient undergoes bypass grafting with a non-vein graft in conjunction with endovascular repair of the descending thoracic aorta to address a blockage in the carotid artery.
2. A provider performs a transcervical retropharyngeal carotid-carotid bypass graft using a synthetic vein graft to bypass a problem area in the carotid artery during endovascular repair of the descending thoracic aorta.
3. Bypass grafting with a non-vein graft is performed in conjunction with endovascular repair of the descending thoracic aorta to address a damaged carotid artery.