Template:CCI Guideline Vascular graft: Difference between revisions

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</noinclude>===Vascular graft guideline===

~~Procedures performed on vascular grafts~~ (~~either synthetic grafts or vessels harvested~~ from ~~elsewhere~~ for use) ~~are coded just as~~ you ~~would if~~ the ~~same thing was done to~~ the ~~native~~ vessel.

Keywords for different kinds of bypasses so this can be found when searching: Axillofemoral bypass grafting / ax-fem bypass, fem-tib bypass, fem-pop bypass, aorto-bi-iliac bypass, aorto-fem bypass

==== Harvesting for the graft ====

If they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the appropriate [[Therapeutic Px]] from [[:Category:Vessel]] with [[Procure, Harvest, Obtain for Further Use]]. Obviously if they use a dacron graft, then there'll be no harvesting.

{{DA | You had written something that seemed contradictory to me: "Thus don't generally include the vessel SUPPLYING the bypass (e.g. in an ax-fem, the femoral is the one blocked and the axillary is supplying the blood to it via a bypass). Now IF they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the vessel taken with Procure, Harvest, Obtain for Further Use." - Do we code the harvest or not? Ttenbergen 21:29, 2020 April 8 (CDT)}}

==== Placing the graft ====

When a graft is used to repair or bypass a native vessel, then you just combine the vessel in question with either '''[[Repair]] or [[Bypass]]''' as appropriate -- i.e. the fact that it was done with a graft is not something we're capturing in CCI at this time.

==== Procedures done to a graft at a later time ====

Procedures performed on vascular grafts (either synthetic grafts or vessels harvested from elsewhere for use) are coded just as you would if the same thing was done to the native vessel.

When something is being done '''to''' a graft that's already in place, the "body part" of the CCI component code isn't the graft but rather is the native vessel that was there before grafting.

{{Ex | Femoral artery dacron graft gets infected and is replaced. The ICD10 diagnosis code would be '''[[Iatrogenic, infection, internal prosthetic device or implant or graft NOS]]''', and the CCI code components would be '''[[(T) Arteries of Leg, NOS]]''' with '''[[Repair]]'''}}

~~{{Discuss|who=Allan~~

~~|question=~~

'''When we have an answer, this information should be moved to [[Template:CCI Guideline Vascular graft]] and linked as appropriate in [[Procure, Harvest, Obtain for Further Use]]. At the least, something linke "such as axillofemoral bypass grafting" needs to go in there so it can be found in future'''

* How do we code Axillofemoral bypass grafting in CCI? Not sure which page to put question on (trial question)

** [https://emedicine.medscape.com/article/1895225-overview This page] makes me think that it will be a two step code, one for [[Procure, Harvest, Obtain for Further Use]] of the [https://en.wikipedia.org/wiki/Axillary_artery axillary artery] (would that be [[(T) Subclavian, Brachiocephalic, Brachial, Arm Arteries]]? if it is included there, that page should be updated to say so...), and one for [[Bypass]] of the femoral artery (coded as [[(T) Arteries of Leg, NOS]] as per that page).

*** If we add this one to [[Template:CCI Guideline Vascular graft]] we should also add what vessels to combine for fem-tib bypass, fem-pop bypass, aorto-bi-iliac bypass, aorto-fem bypass, etc.

*AG REPLY -- code ax-fem bypass as [[(T) Arteries of Leg, NOS]] combined with [[Bypass]]. More generally, for other kinds of vascular bypasses (of which there are many), here are some thoughts:

**The primary CCI coding should be the vessel being bypassed (i.e. the one with the blockage) combined with [[Bypass]]. Thus don't generally include the vessel SUPPLYING the bypass (e.g. in an ax-fem, the femoral is the one blocked and the axillary is supplying the blood to it via a bypass). Now IF they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the vessel taken with [[Procure, Harvest, Obtain for Further Use]]. Obviously if they use a dacron graft, then there'll be no harvesting.

}}

[[Category:Transfusion]]

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 </noinclude>===Vascular graft guideline===
-Procedures performed on vascular grafts (either synthetic grafts or vessels harvested from elsewhere for use) are coded just as you would if the same thing was done to the native vessel.
+Keywords for different kinds of bypasses so this can be found when searching: Axillofemoral bypass grafting / ax-fem bypass, fem-tib bypass, fem-pop bypass, aorto-bi-iliac bypass, aorto-fem bypass
+==== Harvesting for the graft ====
+If they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the appropriate [[Therapeutic Px]] from [[:Category:Vessel]] with [[Procure, Harvest, Obtain for Further Use]].  Obviously if they use a dacron graft, then there'll be no harvesting.
+{{DA | You had written something that seemed contradictory to me: "Thus don't generally include the vessel SUPPLYING the bypass (e.g. in an ax-fem, the femoral is the one blocked and the axillary is supplying the blood to it via a bypass). Now IF they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the vessel taken with Procure, Harvest, Obtain for Further Use." - Do we code the harvest or not? Ttenbergen 21:29, 2020 April 8 (CDT)}}
+==== Placing the graft ====
 When a graft is used to repair or bypass a native vessel, then you just combine the vessel in question with either '''[[Repair]] or [[Bypass]]''' as appropriate -- i.e. the fact that it was done with a graft is not something we're capturing in CCI at this time.
+==== Procedures done to a graft at a later time ====
+Procedures performed on vascular grafts (either synthetic grafts or vessels harvested from elsewhere for use) are coded just as you would if the same thing was done to the native vessel.
 When something is being done '''to''' a graft that's already in place, the "body part" of the CCI component code isn't the graft but rather is the native vessel that was there before grafting.
 {{Ex | Femoral artery dacron graft gets infected and is replaced.  The ICD10 diagnosis code would be '''[[Iatrogenic, infection, internal prosthetic device or implant or graft NOS]]''', and the CCI code components would be '''[[(T) Arteries of Leg, NOS]]''' with '''[[Repair]]'''}}
-{{Discuss|who=Allan
-|question=
-'''When we have an answer, this information should be moved to [[Template:CCI Guideline Vascular graft]] and linked as appropriate in [[Procure, Harvest, Obtain for Further Use]]. At the least, something linke "such as axillofemoral bypass grafting" needs to go in there so it can be found in future'''
-* How do we code Axillofemoral bypass grafting in CCI? Not sure which page to put question on (trial question)
-** [https://emedicine.medscape.com/article/1895225-overview This page] makes me think that it will be a two step code, one for [[Procure, Harvest, Obtain for Further Use]] of the [https://en.wikipedia.org/wiki/Axillary_artery axillary artery] (would that be [[(T) Subclavian, Brachiocephalic, Brachial, Arm Arteries]]? if it is included there, that page should be updated to say so...), and one for [[Bypass]] of the femoral artery (coded as [[(T) Arteries of Leg, NOS]] as per that page).
-*** If we add this one to [[Template:CCI Guideline Vascular graft]] we should also add what vessels to combine for fem-tib bypass, fem-pop bypass, aorto-bi-iliac bypass, aorto-fem bypass, etc.
-*AG REPLY -- code ax-fem bypass as  [[(T) Arteries of Leg, NOS]] combined with [[Bypass]].  More generally, for other kinds of vascular bypasses (of which there are many), here are some thoughts:
-**The primary CCI coding should be the vessel being bypassed (i.e. the one with the blockage) combined with [[Bypass]].  Thus don't generally include the vessel SUPPLYING the bypass (e.g. in an ax-fem, the femoral is the one blocked and the axillary is supplying the blood to it via a bypass).  Now IF they take a vessel from elsewhere (often a vein) to do the bypass, then you can also code the harvest by combining the vessel taken with [[Procure, Harvest, Obtain for Further Use]].  Obviously if they use a dacron graft, then there'll be no harvesting.
 }}
 [[Category:Transfusion]]