Bypass

CCI component 2 codes - what was done
Procedure:	Bypass
CCI 2 code:	76
CCI Collection Mode:	CCI collect first, CCI collect each

"CCI collect first, CCI collect each" is not in the list (CCI collect first, CCI collect each, CCI collect count each, CCI collect count days, CCI collect count units, N/A, CCI collect each day) of allowed values for the "Has CCI Collection Mode" property.

This procedure is a part of CCI Collection. This is one of the CCI component 2 codes - what was done.

Additional Info

See Drainage, Evacuation for a closely related procedure code .

• This is a much broader item than it seems as it includes:
  • Forming an ostomy anywhere -- e.g. colostomy, tracheostomy
  • Vascular bypass or A-V connection -- so for example it includes:
    • CABG
    • aorto-femoral or femoral-popliteal bypass
    • TIPS (Transjugular Intraheptatic Porto systemic Stent)
    • portocaval shunt
    • splenorenal shunt
    • making an A-V fistula for hemodialysis
    • etc.

PEG

• code percutaneous endoscopic gastrostomy (PEG) insertion as
  • (T) Stomach, Pylorus
  • Bypass (this code)

At Task Team Meeting - Rolling Agenda and Minutes#Database Task Group Meeting December 20, 2017 we discussed only coding the placement of a PEG once (ie. set the template at top of this page to "CCI collect first"). That was not represented in the most recent CCI collection mode list. There were other "only once" things in those task minutes, specifically Tracheostomy creation. Do we need to tweak our new list or is the old one just outdated?

• SMW

• Cargo

• Categories

Vascular graft guideline

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

Placing the graft

Code:

• the CCI1 code for the target (bypassed) vessel at which the bypass ends, not the origin vessel from which the bypass (and blood flow) begins.
• the CCI2 code Bypass / Repair as appropriate

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.

Example:

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

Collecting "CCI collect each" items

• "CCI collect each" items are entered each time they happen
• Px Date
  • if an Acquired Procedure, enter the Px Date for each day that they happen
  • if an Admit Procedure leave the date blank
• Px Count
  • if they happen more than once on a day, enter the number of times for that day, otherwise enter a Px Count of 1

Px Date for patients who move

See Px Date#Moves

Alternate CCIs to consider coding instead or in addition

• CCI component 2 codes - what was done

Related ICD10 Codes

Possibly any one in Category:Myocardial Infarction

Related Articles

Imaging Px	Diagnostic Px	Therapeutic Px	Reproductive Px	Musculoskeletal/soft tissue Px
Neuro Px	Respiratory Px	Cardiovascular Px	Gastrointestinal Px	Genitourinary Px	‎Misc Px
CCI_Picklist		CCI component 1 codes - what organ was something done to		CCI component 2 codes - what was done