Please note this question was answered in 2023. The coding advice may or may not be outdated.
Ilio-mesenteric bypass and ilio-hepatic bypass
Question:
Hello! We have a case where a provider did two separate bypasses via 2 arteriotomies and 4 anastomoses off of one vessel (right external iliac). He begins the procedure with a midline abdominal incision, lysis several adhesions due to extensive scar tissue to locate the mesenteric artery. He creates an arteriotomy and a PTFE graft is sewn end-to-side fashion to the right EIA. The graft was tunneled to the level of the SMA and perform an end-to-end anastomosis to the common hepatic artery. An arteriotomy was made and placed a 2nd PTFE graft onto the EIA in the region of the pelvis creating an end-to-side anastomosis and this limb of the mesenteric bypass was then tunneled in this retroperitoneal tissue up to the level of the SMA where an end-to-side anastomosis was created. Provider is choosing codes 35632 for the ilio-hepatic bypass and 35633 for the ilio-SMA bypass. My question is - can two bypasses be reported off of one vessel? If so, are these the correct bypass codes? Also, are lysis of adhesions separately reportable?
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