Summary & Overview
CPT 1019T: Lymphaticovenous Anastomosis for Arm or Leg
CPT code 1019T identifies a surgical lymphaticovenous anastomosis performed on a single arm or leg to restore lymphatic drainage by directly connecting lymphatic vessels to veins. The procedure can be done with or without robotic assistance and addresses lymphedema and related lymphatic drainage disorders. Nationally, this code matters as advanced microsurgical options for lymphedema expand and payers evaluate coverage policies and coding pathways for complex reconstructive procedures.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, the typical sites of service (hospital operating rooms and ambulatory surgery centers), and what standard documentation should emphasize for surgical lymphatic-venous connections. The publication summarizes common coverage themes and benchmark considerations when available, highlights relevant policy and coding updates that affect billing and prior authorization workflows, and outlines clinical indications that commonly accompany claims submissions.
This executive summary equips clinicians, billing teams, and policy analysts with a clear understanding of CPT code 1019T, where the service is typically delivered, and the payer landscape relevant to national reimbursement and coverage discussions.
Billing Code Overview
CPT code 1019T describes a surgical procedure to connect lymphatic vessels to nearby veins in one arm or one leg to reroute lymph fluid into the bloodstream. The procedure may be performed with or without robotic assistance.
-
Service type: Surgical lymphatic microsurgery (lymphaticovenous anastomosis)
-
Typical site of service: Hospital operating room or ambulatory surgery center
Data not available in the input for payers, modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic, limb-threatening lymphedema of a single upper or lower extremity refractory to conservative therapy (compression, manual lymphatic drainage, and physical therapy). The patient presents with progressive swelling, recurrent cellulitis, activity limitations, and quality-of-life impairment despite conservative measures for 6–12 months. Preoperative workup includes history and physical exam, limb volume measurements or perometry, duplex ultrasonography to exclude deep venous thrombosis, lymphoscintigraphy or indocyanine green (ICG) lymphography to map functional lymphatic channels, and routine preoperative labs. The surgical workflow includes preoperative mapping, general or regional anesthesia, incision and microsurgical dissection to identify lymphatic vessels and adjacent veins in the affected arm or leg, performance of lymphaticovenous anastomosis(s) to restore drainage, possible use of robotic assistance if available, intraoperative assessment of anastomotic patency (fluorescence or dye), wound closure, and postoperative plan with limb elevation, pulse compression and staged rehabilitation. Follow-up includes surveillance for patency, wound healing, and functional outcome assessments. Typical site of service is an outpatient surgical center or hospital operating room with microsurgical capabilities; observation or short inpatient stay may be required for higher-risk patients or complex reconstructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
GA | Waiver of liability statement on file, voluntary under payer policy | When patient has a known non-covered service and signed ABN/waiver per payer rules |