Bypass

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

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

Additional Info

Includes

• This is a much broader item than it seems as it includes:
  • Forming an ostomy anywhere -- e.g. colostomy combine with (T) Large Intestine
    • Exception: Nephrostomy placement
  • Vascular bypass or A-V connection -- so for example it includes:
    • CABG, combine with (T) Coronary Arteries
    • aorto-femoral or femoral-popliteal bypass
    • TIPS (Transjugular Intraheptatic Porto systemic Stent) see CCI Picklist
    • portocaval shunt
    • splenorenal shunt
    • making an A-V fistula for hemodialysis, combine with (T) Artery with Vein, NOS
    • etc.
    • for femoral popliteal bypass code (T) Arteries of Leg, NOS combined with Bypass
• Hepatojejunostomy - code (T) Gallbladder, Bile Ducts + Bypass
• for mucous fistula in relation to a colostomy, combine this with (T) Surgically Constructed Sites in Digestive and Biliary Tract
• gastrojejunostomy combine (T) Small Intestine & Bypass

Excludes

• PEG -- see Implantation of Internal Device
• Tracheostomy creation

• See Drainage, Evacuation for a closely related procedure code .

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

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