CCSD code L1620 – Axillo-unifemoral bypass (vascular surgery)

Key takeaways

CCSD code L1620 describes an axillo-unifemoral bypass, a graft from the axillary artery to one femoral artery.

The code sits in CCSD Chapter 9 Vascular system, sub-chapter 9.4.0 Abdominal vessels, under schedule reference FI.022.

CCSD lists L1680, L6710 and L7010 as unacceptable combinations with L1620 on the same claim.

Older references may still show the previous description, “Axillo-femoral bypass”, for the same code.

The operation note should name the side, the axillary inflow and the femoral target, so the insurer can see one groin was grafted.

CCSD code L1620 covers a one-sided axillo-femoral graft

CCSD code L1620 is the UK insurer billing code for an axillo-unifemoral bypass. The surgeon joins a graft to the axillary artery below the collarbone. The graft then runs under the skin of the chest and flank to the femoral artery in one groin.

Surgeons call this route extra-anatomic because it avoids the abdomen. It restores blood flow to a leg when direct surgery on the aorta carries too much risk. Typical cases include frail patients and patients with an infected aortic graft.

In the CCSD schedule, L1620 is a procedural code with reference FI.022. CCSD stands for Clinical Coding & Schedule Development, the group that maintains the codes UK private insurers accept. For background on that process, see our guide to how insurers apply CCSD codes.

The public CCSD record carries two dates that don’t agree. It lists a date inactive of 1 January 2006 and a date created of 20 January 2010. Check L1620 in the CCSD schedule members’ area before you bill it.

L1620 sits inside the vascular surgery chapter

CCSD groups most open vascular operations under Chapter 9, Vascular system. That chapter splits into eight sub-chapters by body region and procedure type.

• 9.1.0 Head and neck
• 9.2.0 Thoracic
• 9.3.0 Renal
• 9.4.0 Abdominal vessels, home of L1620
• 9.5.0 Ileo-femoral vessels
• 9.6.0 Non-specific
• 9.7.0 Varicose veins
• 9.8.0 Lymphatic system

Sub-chapter 9.4.0 holds aortic and visceral artery work. Alongside L1620, it lists open aortic aneurysm repairs such as L1960. Bypasses that start at the aorta or iliac arteries mostly live in 9.5.0 instead.

That split matters when you search the schedule. A coder who looks only under ileo-femoral codes won’t find the axillary-inflow bypasses at all. For codes in other sub-chapters, browse our CCSD billing guides by code number.

Neighboring bypass codes are easy to swap

In the public CCSD data for 9.4.0, L1620 and L1680 are the only codes in the L16 run. The other close matches sit in 9.5.0. Each one differs by where the graft starts or how many groins it reaches.

Read the operation note for two facts before you choose. Where does the inflow come from, and how many groins does the graft reach? Those two answers separate every code in this table.

Three codes can’t share a claim with L1620

CCSD lists three unacceptable combinations for L1620. A claim that carries L1620 with any of them is likely to come back from the insurer.

When the note describes grafts to both groins, L1680 replaces L1620. Never bill both. If the surgeon also removed clot during the bypass, record it in the note rather than as a separate L7010 line.

An artery biopsy taken during the same operation stays off the bill too. L6710 applies only when the biopsy is the sole procedure.

A documentation checklist keeps the L1620 claim clean

Insurers query bypass claims when the note leaves the route unclear. Use this checklist before the bill goes out.

• Side: state the femoral artery that receives the graft, left or right.
• Inflow: name the axillary artery used and its side.
• Target: record the femoral branch, such as common or deep femoral.
• Graft: note the material, such as a prosthetic or vein graft.
• Indication: explain why the surgeon chose an extra-anatomic route.
• Diagnosis: add the ICD-10 code that matches the indication.
• Other procedures: list every extra step and check its code against the combinations above.
• Insurer details: include the membership number and any authorization reference the policy required.

L1620 needs a matching diagnosis and OPCS-4 code

UK insurers expect a WHO ICD-10 diagnosis alongside the CCSD code. For limb ischemia from narrowed arteries, that is often I70.2, atherosclerosis of arteries of extremities. For an infected aortic graft, T82.7 covers infection due to vascular grafts.

The hospital codes the same operation in OPCS-4, the NHS procedure classification. Its category L16 covers extra-anatomic bypass of the aorta. L16.1 covers an emergency axillary-to-femoral bypass and L16.2 the other cases. L16.3 is the bilateral version. Match your CCSD code to the hospital’s OPCS-4 record before you submit.

Common L1620 mistakes send claims back

These six slips come straight from the code’s scope and its CCSD clash list. Each one has a quick fix.

Pabau keeps insurer claims moving for surgical practices

Many private surgical practices still key insurer bills by hand. A secretary copies codes, membership numbers and dates from the notes into a portal. One missed field can send the bill back weeks later.

Pabau pulls those details from the patient record instead, for faster claims management. The software pre-fills each claim and checks required fields, such as membership numbers, before you send it. UK claims then go to the insurer through Pabau’s Healthcode integration.

Fewer claims stall over a missing membership number. Your secretary stops re-keying the same details into a portal, and remittances stop waiting on queries.

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Conclusion

L1620 is easy to bill correctly once the operation note does its job. One groin means L1620, two groins mean L1680, and the two never share a claim.

The open question is the code’s status. Its public dates conflict, so a quick check in the CCSD members’ area costs less than a returned claim weeks later.

Put the side, inflow and graft into every note, and most insurer queries never start. Book a demo to see how Pabau turns your patient records into complete insurer claims.

Continue your research

Billing aortic aneurysm repairs? CCSD code L1960: Infrarenal AAA bifurcation graft covers the open bifurcation graft in the same sub-chapter.

Coding a revision of an aortic graft? CCSD code L2200: Revision of prosthesis of abdominal aorta explains when a revision code applies.

Working on femoral artery procedures? CCSD code L6000: Endarterectomy of femoral artery covers femoral endarterectomy billing.

New to CCSD billing? CCSD billing reference for insurers shows how UK private insurers apply CCSD codes.

Want fewer returned claims? Claims management software shows how Pabau prepares and sends insurer claims.

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