How To Use CPT Code 35256

CPT 35256 describes the repair of an abnormal or injured blood vessel in the lower extremity using a vein graft. 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 35256?

CPT 35256 is used to describe the repair of an abnormal or injured blood vessel in the lower extremity with a vein graft. This code is used when a provider makes an incision on the lower extremity to access the vessel requiring repair. The provider then sutures the graft into place to repair the vessel and checks for normal blood flow through the repaired vessel.

2. Official Description

The official description of CPT code 35256 is: ‘Repair blood vessel with vein graft; lower extremity.’

3. Procedure

1. The provider prepares the patient and makes an incision on the lower extremity to access the blood vessel requiring repair.
2. The provider dissects and moves soft tissue and vessels as necessary to reach the target area.
3. If a graft is needed, the provider makes an incision at another site on the body and harvests the vein, such as the saphenous vein.
4. The provider prepares the graft and sutures it into place to repair the blood vessel.
5. The provider checks for normal blood flow through the repaired vessel, possibly using a Doppler probe.
6. The provider sutures the incision to complete the procedure.

4. Qualifying circumstances

CPT 35256 is used when a patient has an abnormal or injured blood vessel in the lower extremity that requires repair. The procedure involves the use of a vein graft, such as the saphenous vein. The provider must perform the procedure on the lower extremity and ensure that the patient is appropriately prepped and anesthetized.

5. When to use CPT code 35256

CPT code 35256 should be used when a provider performs a repair of an abnormal or injured blood vessel in the lower extremity using a vein graft. This code should not be used for repairs involving grafts other than veins or for repairs in other areas of the body.

6. Documentation requirements

To support a claim for CPT 35256, the provider must document the following information:

• Patient’s diagnosis indicating the need for the repair
• Details of the procedure, including the use of a vein graft
• Date of the procedure
• Incision site and location of the graft
• Confirmation of normal blood flow through the repaired vessel
• Details of any additional procedures performed, if applicable
• Provider’s signature

7. Billing guidelines

When billing for CPT 35256, ensure that the procedure involves the repair of an abnormal or injured blood vessel in the lower extremity using a vein graft. This code should not be reported with other codes unless additional procedures are performed. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 35256 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider repairs an abnormal blood vessel in the lower extremity of a patient using a vein graft.
2. A surgeon performs a procedure to repair an injured blood vessel in the lower extremity with a saphenous vein graft.
3. A vascular specialist sutures a vein graft into place to repair an abnormal blood vessel in the lower extremity.
4. A provider checks for normal blood flow through a repaired blood vessel in the lower extremity after using a vein graft.
5. A surgeon performs a successful repair of an injured blood vessel in the lower extremity using a vein graft.
6. A vascular specialist documents the details of a repair procedure involving a vein graft in the lower extremity.
7. A provider completes the repair of an abnormal blood vessel in the lower extremity with a vein graft.
8. A surgeon confirms normal blood flow through a repaired blood vessel in the lower extremity after using a vein graft.
9. A vascular specialist performs a repair procedure on an injured blood vessel in the lower extremity using a vein graft.
10. A provider sutures an incision after repairing an abnormal blood vessel in the lower extremity with a vein graft.