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Official Description

Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Embolectomy or thrombectomy is a surgical procedure aimed at removing an obstruction from a blood vessel, specifically targeting the innominate or subclavian artery through a thoracic incision. This procedure is essential when an embolus, which is a blood clot or other debris that has traveled from another part of the body, becomes lodged in these arteries, impeding blood flow. The obstruction can also be due to a thrombus, which is a clot that forms in situ within the artery, often in areas that are narrowed or stenotic. The innominate artery branches off from the aorta and supplies blood to the right arm and head, while the subclavian artery supplies blood to the arms. The presence of an embolus or thrombus in these arteries can lead to serious complications, including ischemia or infarction of the tissues supplied by these vessels. The procedure can be performed with or without the assistance of a catheter, depending on the specific circumstances of the obstruction. The thoracic approach allows for direct access to the affected artery, facilitating the removal of the clot while minimizing the risk of dislodging it into the cerebral circulation, which could lead to a stroke. Following the removal of the obstruction, angiography may be conducted to confirm that the artery is clear and that normal blood flow has been restored.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The embolectomy or thrombectomy procedure is indicated for the following conditions:

  • Embolism in the Innominate or Subclavian Artery - This condition occurs when an embolus, which is a blood clot or other material, travels from a distant site and lodges in the innominate or subclavian artery, obstructing blood flow.
  • Thrombosis in the Innominate or Subclavian Artery - This condition arises when a thrombus forms within the artery, typically in areas that are narrowed or stenotic, leading to reduced or blocked blood flow.
  • Complications from Myocardial Infarction - Patients with a history of myocardial infarction may develop emboli that can migrate to the innominate or subclavian arteries, necessitating intervention.
  • Rheumatic Heart Disease - Individuals with rheumatic heart disease may also be at risk for embolic events, which can lead to obstruction in the innominate or subclavian arteries.

2. Procedure

The embolectomy or thrombectomy procedure involves several critical steps to ensure the effective removal of the obstruction from the innominate or subclavian artery.

  • Step 1: Anesthesia and Positioning - The patient is placed under general anesthesia, and appropriate positioning is ensured to provide optimal access to the thoracic area.
  • Step 2: Median Sternotomy - A median sternotomy is performed to gain access to the thoracic cavity. This involves making an incision along the sternum to expose the innominate and subclavian arteries.
  • Step 3: Identification of the Affected Artery - The surgeon identifies the innominate or subclavian artery where the embolus or thrombus is located. Care is taken to visualize the area clearly to avoid complications.
  • Step 4: Control of Blood Flow - Vessel loops may be placed proximal and distal to the site of obstruction to control blood flow during the procedure, ensuring that the area remains clear for intervention.
  • Step 5: Removal of the Embolus or Thrombus - The surgeon may choose to remove the clot directly through an incision in the artery or utilize a catheter-based approach. If using a catheter, a balloon catheter is inserted beyond the clot, inflated, and then withdrawn to capture and remove the obstruction.
  • Step 6: Verification of Arterial Patency - After the removal of the embolus or thrombus, an angiography may be performed to confirm that the artery is patent and that all clot material has been successfully removed.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any complications, such as bleeding or signs of ischemia. Patients may require imaging studies to ensure that blood flow has been restored adequately. Recovery typically involves a hospital stay where vital signs are closely monitored, and pain management is provided. The healthcare team will also assess the patient's neurological status to ensure there are no adverse effects from the procedure. Follow-up appointments will be scheduled to evaluate the long-term success of the procedure and to manage any underlying conditions that may have contributed to the embolic or thrombotic event.

Short Descr REMOVAL OF ARTERY CLOT
Medium Descr EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY
Long Descr Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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