How To Use CPT Code 35351

CPT 35351 describes a surgical procedure known as thromboendarterectomy, specifically for the iliac artery. This article will provide an overview of CPT code 35351, 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 35351?

CPT 35351 is a code used to describe a surgical procedure called thromboendarterectomy, which involves the removal of thrombus and plaques from the iliac artery. This procedure is performed by a healthcare provider to restore normal blood flow and maintain the integrity of the artery.

2. Official Description

The official description of CPT code 35351 is: ‘Thromboendarterectomy, including patch graft, if performed; iliac.’

3. Procedure

1. The healthcare provider begins by making an incision in the abdomen to access the iliac artery.
2. If necessary, the provider may harvest a vein to create a graft, making an incision over the vein, excising the graft, and tying off the donor vein ends.
3. The provider then prepares the graft, whether it is artificial material, autologous tissue, or preserved tissue from a donor.
4. Vascular clamps are placed as needed for the iliac procedure, and the artery is opened.
5. The provider performs an endarterectomy, removing the portion of the artery affected by thrombus or atherosclerosis.
6. To maintain a normal inner diameter of the artery, the provider removes the intima, or the inner lining, of the artery.
7. If necessary, a patch graft may be placed to cover the defect or replace the removed tissue.
8. The arterial opening is closed with sutures, and the clamps are removed to restore normal blood flow.
9. The provider then closes the incision in layers, ensuring hemostasis.

4. Qualifying circumstances

CPT 35351 is used when a patient requires a thromboendarterectomy procedure specifically for the iliac artery. This procedure is typically performed on patients with atherosclerosis, a chronic disease characterized by the abnormal thickening of artery walls due to fatty deposits. The patient must have a medical need for the procedure, and the healthcare provider must determine that the benefits outweigh the risks.

5. When to use CPT code 35351

CPT code 35351 should be used when a healthcare provider performs a thromboendarterectomy procedure on the iliac artery. It is important to note that this code is specific to the iliac artery and should not be used for procedures on other arteries or veins.

6. Documentation requirements

To support a claim for CPT code 35351, the healthcare provider must document the following information:

• Patient’s diagnosis and medical necessity for the procedure
• Details of the procedure, including the use of a patch graft if performed
• Date of the procedure
• Incision site and approach
• Specific steps taken during the procedure, such as the removal of thrombus and plaques
• Use of any additional materials or devices
• Closure technique and any post-procedure instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 35351, ensure that the procedure performed is a thromboendarterectomy specifically for the iliac artery. It is important to follow the appropriate coding guidelines and modifiers, if applicable, to accurately report the procedure. Additionally, be aware of any specific billing requirements from insurance providers or government payers.

8. Historical information

CPT code 35351 was added to the Current Procedural Terminology system on January 1, 1990. There have been some historical changes to the code, including a code change on January 1, 2007, which revised the description to include the option of a patch graft. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A healthcare provider performs a thromboendarterectomy on the iliac artery of a patient with atherosclerosis to remove thrombus and plaques.
2. During a surgical procedure, a surgeon performs a thromboendarterectomy on the iliac artery, including the placement of a patch graft.
3. A patient with a history of iliac artery thrombosis undergoes a thromboendarterectomy procedure to restore normal blood flow.
4. A vascular surgeon performs a thromboendarterectomy on the iliac artery of a patient with peripheral arterial disease.
5. During a surgical intervention, a healthcare provider performs a thromboendarterectomy on the iliac artery to address a blockage caused by thrombus and atherosclerosis.
6. A patient with a diagnosed iliac artery stenosis undergoes a thromboendarterectomy procedure to improve blood flow.
7. A surgeon performs a thromboendarterectomy on the iliac artery of a patient with a history of recurrent thrombosis.
8. A healthcare provider performs a thromboendarterectomy on the iliac artery of a patient with symptoms of claudication.
9. During a surgical procedure, a vascular surgeon performs a thromboendarterectomy on the iliac artery to remove thrombus and plaques.
10. A patient with a diagnosed iliac artery aneurysm undergoes a thromboendarterectomy procedure to prevent further complications.