How To Use CPT Code 35246

CPT 35246 describes the repair of an abnormal or injured intrathoracic blood vessel with a vein graft, without the use of cardiopulmonary bypass. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35246?

CPT 35246 is used to describe the repair of an abnormal or injured blood vessel located within the chest, using a vein graft. This procedure does not involve the use of cardiopulmonary bypass, which is a technique that allows the patient’s blood to bypass the heart and lungs during surgery. The repair is performed by a healthcare provider who makes an incision in the chest to access the vessel in need of repair. The provider then sutures the vein graft into place to restore normal blood flow through the vessel.

2. Official Description

The official description of CPT code 35246 is: ‘Repair blood vessel with vein graft; intrathoracic, without bypass.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made in the chest to access the abnormal or injured blood vessel.
3. The provider carefully dissects and moves surrounding tissue, organs, and vessels to reach the target area.
4. If a vein graft is needed, the provider makes an incision at another site on the body and harvests a suitable vein, such as the saphenous vein.
5. The harvested vein graft is prepared and sutured into place to repair the abnormal or injured blood vessel.
6. The provider checks for normal blood flow through the repaired vessel, often using a Doppler ultrasound.
7. The incision in the chest is closed with sutures.

4. Qualifying circumstances

CPT 35246 is used when a patient requires the repair of an abnormal or injured blood vessel located within the chest. The procedure involves the use of a vein graft to restore normal blood flow through the vessel. It is important to note that this code specifically applies to cases where cardiopulmonary bypass is not utilized.

5. When to use CPT code 35246

CPT code 35246 should be used when a healthcare provider performs the repair of an intrathoracic blood vessel using a vein graft, without the use of cardiopulmonary bypass. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 35246, the healthcare provider must document the following information:

• Patient’s diagnosis necessitating the repair of the intrathoracic blood vessel
• Details of the procedure, including the use of a vein graft and absence of cardiopulmonary bypass
• Date of the procedure
• Incision site and size
• Specific vein graft used, if applicable
• Confirmation of normal blood flow through the repaired vessel
• Closure of the incision with sutures
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 35246, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The repair must involve an intrathoracic blood vessel, utilize a vein graft, and be performed without the use of cardiopulmonary bypass. It is also important to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT 35246 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare billing purposes.

9. Examples

1. A healthcare provider repairs an intrathoracic blood vessel using a vein graft, without the use of cardiopulmonary bypass, in a patient with a congenital heart defect.
2. A surgeon performs the repair of an abnormal blood vessel located within the chest using a vein graft, without cardiopulmonary bypass, in a patient who experienced a traumatic injury.
3. A cardiovascular specialist sutures a vein graft into place to repair an intrathoracic blood vessel in a patient with atherosclerosis, without the use of cardiopulmonary bypass.
4. A thoracic surgeon performs the repair of an abnormal blood vessel using a vein graft, without cardiopulmonary bypass, in a patient with a thoracic aortic aneurysm.
5. A cardiac surgeon repairs an intrathoracic blood vessel using a vein graft, without the use of cardiopulmonary bypass, in a patient with a history of coronary artery disease.
6. A vascular surgeon sutures a vein graft into place to repair an abnormal blood vessel located within the chest, without cardiopulmonary bypass, in a patient with a pulmonary embolism.
7. An interventional radiologist performs the repair of an intrathoracic blood vessel using a vein graft, without the use of cardiopulmonary bypass, in a patient with a thoracic outlet syndrome.
8. A cardiothoracic surgeon sutures a vein graft into place to repair an abnormal blood vessel in a patient with a mediastinal tumor, without cardiopulmonary bypass.
9. A vascular surgeon repairs an intrathoracic blood vessel using a vein graft, without the use of cardiopulmonary bypass, in a patient with a history of radiation therapy.
10. A cardiac surgeon performs the repair of an abnormal blood vessel located within the chest using a vein graft, without cardiopulmonary bypass, in a patient with aortic dissection.