How To Use CPT Code 35266

CPT 35266 describes the repair of an abnormal or injured blood vessel in the upper extremity using a non-venous 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 35266?

CPT 35266 can be used to describe the repair of an abnormal or injured blood vessel in the upper extremity using a non-venous graft. This code is used when a provider makes an incision in the skin of the upper extremity to access the vessel requiring repair. The provider then sutures a non-venous graft into place to repair the vessel, ensuring normal blood flow through the repaired vessel.

2. Official Description

The official description of CPT code 35266 is: ‘Repair blood vessel with graft other than vein; upper extremity.’

3. Procedure

1. The provider prepares and anesthetizes the patient.
2. An incision is made in the skin of the upper extremity to access the vessel requiring repair.
3. The provider dissects and moves soft tissue and vessels as necessary to reach the target area.
4. Bleeding is controlled manually.
5. The extremity vessel is clamped proximally and distally to the defect.
6. A non-venous graft, typically synthetic, is sutured into place to repair the vessel.
7. The provider checks for normal blood flow through the repaired vessel, possibly using a Doppler probe.
8. The incision is repaired with sutures.

4. Qualifying circumstances

CPT 35266 is used when there is an abnormal or injured blood vessel in the upper extremity that requires repair. The procedure involves the use of a non-venous graft to restore normal blood flow. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 35266

CPT code 35266 should be used when a provider performs a repair of an abnormal or injured blood vessel in the upper extremity using a non-venous graft. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 35266, the provider must document the following information:

• Patient’s diagnosis indicating the need for vessel repair
• Details of the procedure, including the use of a non-venous graft
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information, such as the use of a Doppler probe to check blood flow
• Provider’s signature

7. Billing guidelines

When billing for CPT 35266, ensure that the procedure meets the specific criteria outlined in the code description. It is important to use the appropriate CPT code based on the specific circumstances of the procedure. Additionally, be aware of any guidelines regarding reporting CPT code 35266 with other codes. Consider using modifiers if necessary to accurately represent the services provided.

8. Historical information

CPT 35266 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A surgeon repairs an abnormal blood vessel in the upper extremity using a synthetic graft.
2. A vascular specialist sutures a non-venous graft to repair an injured blood vessel in the upper extremity.
3. A cardiothoracic surgeon performs a procedure to restore normal blood flow in an abnormal blood vessel in the upper extremity using a non-venous graft.
4. An interventional radiologist repairs an injured blood vessel in the upper extremity with a synthetic graft.
5. A vascular surgeon uses a non-venous graft to repair an abnormal blood vessel in the upper extremity.
6. A provider performs a procedure to restore normal blood flow in an injured blood vessel in the upper extremity using a non-venous graft.
7. An interventional cardiologist repairs an abnormal blood vessel in the upper extremity with a synthetic graft.
8. A vascular specialist sutures a non-venous graft to restore normal blood flow in an injured blood vessel in the upper extremity.
9. A surgeon repairs an injured blood vessel in the upper extremity using a non-venous graft.
10. An interventional radiologist performs a procedure to restore normal blood flow in an abnormal blood vessel in the upper extremity using a synthetic graft.