How To Use CPT Code 35304

CPT 35304 describes a specific procedure known as thromboendarterectomy, which involves the removal of thrombus and plaques from the tibioperoneal trunk artery. This article will provide an overview of CPT code 35304, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35304?

CPT 35304 is a code used to describe a surgical procedure called thromboendarterectomy. This procedure involves the removal of thrombus and plaques from the tibioperoneal trunk artery. It is typically performed by a healthcare provider who is experienced in vascular surgery.

2. Official Description

The official description of CPT code 35304 is: ‘Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery.’

3. Procedure

1. The healthcare provider begins by making an incision in the skin of the leg over the tibioperoneal trunk artery.
2. They then dissect the tissue to access the artery.
3. If necessary, the provider may harvest a vein to create a graft, making an incision over the vein and excising the graft.
4. Vascular clamps are placed as needed to facilitate the surgery.
5. The provider opens the artery and performs an endarterectomy, removing the portion of the artery affected by thrombus or atherosclerosis.
6. If required, a synthetic or homogenous patch graft may be placed.
7. The arterial opening is closed with sutures, and the clamps are removed to restore normal blood flow.
8. The provider then closes the skin incision in layers to ensure proper healing.

4. Qualifying circumstances

CPT 35304 is used for patients who require thromboendarterectomy of the tibioperoneal trunk artery. This procedure is typically performed on individuals with atherosclerosis or thrombus formation in this specific artery. The patient must be appropriately prepped and anesthetized, and the surgery should be performed by a healthcare provider experienced in vascular surgery.

5. When to use CPT code 35304

CPT code 35304 should be used when a healthcare provider performs a thromboendarterectomy on the tibioperoneal trunk artery. It is important to ensure that the procedure is performed on the correct artery and that the documentation supports the use of this specific code.

6. Documentation requirements

To support a claim for CPT 35304, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for thromboendarterectomy
• Details of the procedure, including the specific artery involved
• Incision site and closure method
• Use of a patch graft, if performed
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 35304, it is important to ensure that the procedure was performed on the tibioperoneal trunk artery. The documentation should support the use of this specific code, and any additional procedures or complications should be appropriately documented and billed separately if necessary.

8. Historical information

CPT code 35304 was added to the Current Procedural Terminology system on January 1, 2007. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A vascular surgeon performing a thromboendarterectomy on the tibioperoneal trunk artery to remove thrombus and plaques.
2. A patient with atherosclerosis in the tibioperoneal trunk artery undergoing a thromboendarterectomy to restore normal blood flow.
3. A healthcare provider performing a thromboendarterectomy on the tibioperoneal trunk artery and using a patch graft to repair the artery.
4. A patient with thrombus formation in the tibioperoneal trunk artery undergoing a thromboendarterectomy to prevent further complications.
5. A healthcare provider performing a thromboendarterectomy on the tibioperoneal trunk artery as part of a larger vascular surgery procedure.
6. A patient with a history of thrombus formation in the tibioperoneal trunk artery undergoing a repeat thromboendarterectomy to address recurrent blockages.
7. A healthcare provider performing a thromboendarterectomy on the tibioperoneal trunk artery using a synthetic patch graft to repair the artery.
8. A patient with atherosclerosis in the tibioperoneal trunk artery undergoing a thromboendarterectomy to improve blood flow and alleviate symptoms.
9. A healthcare provider performing a thromboendarterectomy on the tibioperoneal trunk artery as part of a larger treatment plan for peripheral artery disease.
10. A patient with a history of thrombus formation in the tibioperoneal trunk artery undergoing a thromboendarterectomy to prevent future complications.