How To Use CPT Code 35306

CPT 35306 describes the additional thromboendarterectomy procedure performed on an additional tibial or peroneal artery, in conjunction with the primary procedure. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35306?

CPT 35306 is used to describe the additional thromboendarterectomy procedure performed on an additional tibial or peroneal artery, in conjunction with the primary procedure. This code is used when the provider removes thrombus or plaques from an additional tibial or peroneal artery during the same session as a separately reportable thromboendarterectomy procedure for the initial tibial or peroneal artery.

2. Official Description

The official description of CPT code 35306 is: ‘Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the primary procedure code for thromboendarterectomy (CPT code 35305). It is important to note that CPT codes 35304, 35305, and 35306 should not be reported in conjunction with CPT codes 37229, 37231, 37233, or 37235 when performed in the same vessel.

3. Procedure

1. At the same session as the primary procedure for thromboendarterectomy of an initial tibial or peroneal artery, the provider performs the additional thromboendarterectomy on each additional tibial or peroneal artery.
2. The patient is appropriately prepped and anesthetized.
3. The provider makes an incision in the skin of the leg over the second or subsequent tibial or peroneal artery treated.
4. Tissue is dissected to access the artery.
5. If a graft is needed, the provider makes an incision over the vein, excises the graft, ties off the donor vein ends, and preps the graft.
6. Vascular clamps are placed on the tibial or peroneal artery as needed, and the artery is opened.
7. The provider performs an endarterectomy to remove the portion of the artery where the thrombus or atherosclerosis has formed.
8. If necessary, a synthetic or homogenous patch graft is placed, and the arterial opening is closed with sutures.
9. The clamps are removed to restore normal blood flow, and the skin incision is closed in layers after ensuring hemostasis.

4. Qualifying circumstances

CPT 35306 is performed when the provider needs to remove thrombus or plaques from an additional tibial or peroneal artery during the same session as the primary procedure for thromboendarterectomy of an initial tibial or peroneal artery. This procedure is typically performed on patients with atherosclerosis, a chronic disease characterized by abnormal thickening of the artery walls due to fatty deposits. The provider must ensure that the patient is appropriately prepped and anesthetized before performing the procedure.

5. When to use CPT code 35306

CPT code 35306 should be used when the provider performs the additional thromboendarterectomy procedure on an additional tibial or peroneal artery during the same session as the primary procedure for thromboendarterectomy of an initial tibial or peroneal artery. It is important to note that this code should only be reported in conjunction with the primary procedure code for thromboendarterectomy (CPT code 35305).

6. Documentation requirements

To support a claim for CPT code 35306, the provider must document the following information:

• Indication for the primary procedure and the need for the additional thromboendarterectomy
• Specific details of the procedure, including the number of additional tibial or peroneal arteries treated
• Date of the procedure
• Start and end time of the procedure
• Details of the surgical technique used, including any patch graft performed
• Any complications or adverse events encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 35306, ensure that the procedure is performed in conjunction with the primary procedure for thromboendarterectomy (CPT code 35305). It is important to note that CPT codes 35304, 35305, and 35306 should not be reported in conjunction with CPT codes 37229, 37231, 37233, or 37235 when performed in the same vessel. It is also important to include the appropriate primary procedure code for thromboendarterectomy when reporting CPT code 35306. Remember that CPT code 35306 is an add-on code and should not be reported without an appropriate primary code.

8. Historical information

CPT code 35306 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition. It is important to note that CPT code 35306 was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a thromboendarterectomy procedure on the anterior tibial artery and an additional thromboendarterectomy procedure on the posterior tibial artery during the same session.