This page addresses follow-up questions and additional information pertinent to our webinar
CABG Coding: Navigating the Heart of the Matter.

** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q:  One of my providers has started doing “off-pump” CABG procedures, is this coded differently from a CABG with cardiopulmonary bypass?
A:  This is not coded any differently. The CABG codes include the CPB when performed but are still applicable if CPB is not used. If the provider documents that the CABG was more difficult due to trying to anastomose the grafts on a beating heart, then modifier 22 could be applied. This is only recommended based on provider documentation, and be prepared to submit the operative report for review.

Q:  I know that harvesting the graft is included in the CABG codes, but what if the PA that is assisting the case does the harvesting?
A:  You are correct, the graft procurement is included, with a few exceptions as per the guidelines, such as harvesting the radial artery or using an endoscopic technique. However, if the assistant surgeon harvests a graft that is included, then CPT guidelines direct us to report the primary procedure with modifier 80. For example, a single vein CABG reported with CPT 33510 includes harvest of the saphenous vein, so if the PA does that portion the only 90-day we can do is report 33510 – AS

Q:  If we are returning to the OR more than 1 month after a prior valve procedure, but still within the 90-day global, and are going to use the re-operation code, 33530. do we still need to use a global surgery modifier, like 58 or 79?
A:  Great question. Yes, a global modifier will need to be used depending on the reason for the return to OR. CPT 33530 is an add-on code, so it doesn’t require a modifier because it is always reported with a primary procedure. The primary procedure will need to appropriate modifier appended.