How To Use CPT Code 35355

CPT 35355 describes a specific procedure known as thromboendarterectomy, which involves the removal of thrombus and plaques from an iliofemoral artery. This article will provide an overview of CPT code 35355, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when to use this code.

1. What is CPT Code 35355?

CPT 35355 is a code used to describe the surgical procedure known as thromboendarterectomy. This procedure involves the removal of thrombus and plaques from an iliofemoral artery. It is typically performed by a healthcare provider who makes an incision in the skin of the pelvis and groin to access the iliofemoral artery. The provider then removes the portion of the artery where the thrombus or atherosclerosis has formed, ensuring that the inner diameter of the artery is maintained. In some cases, a patch graft may be used to cover the defect or replace the removed tissue. The procedure concludes with the closure of the arterial opening and the skin incision.

2. Official Description

The official description of CPT code 35355 is: ‘Thromboendarterectomy, including patch graft, if performed; iliofemoral.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring that they are appropriately prepped and anesthetized.
2. An incision is made in the skin of the pelvis and groin to access the iliofemoral artery.
3. If necessary, a vein may be harvested to create a graft. The provider makes an incision over the vein, excises the graft, ties off the donor vein ends, and prepares the graft.
4. Vascular clamps are placed as needed for the iliofemoral procedure, and the artery is opened.
5. The provider performs an endarterectomy, removing the portion of the artery affected by the thrombus or atherosclerosis.
6. If required, a synthetic or homogenous patch graft may be placed to cover the defect or replace the removed tissue.
7. The arterial opening is closed with sutures, and the clamps are removed to restore normal blood flow.
8. The provider closes the skin incision in layers, ensuring hemostasis.

4. Qualifying circumstances

CPT code 35355 is used for patients who require thromboendarterectomy of the iliofemoral artery. This procedure is typically performed on individuals with atherosclerosis, a chronic disease characterized by the abnormal thickening of artery walls due to fatty deposits. The procedure is performed by a qualified healthcare provider who has the necessary expertise and training in performing thromboendarterectomy procedures.

5. When to use CPT code 35355

CPT code 35355 should be used when a healthcare provider performs a thromboendarterectomy procedure on the iliofemoral artery. It is important to note that this code should not be used for other types of thromboendarterectomy procedures or for procedures performed on different arteries or veins.

6. Documentation requirements

To support a claim for CPT code 35355, the healthcare provider must document the following information:

• Patient’s diagnosis necessitating the thromboendarterectomy procedure
• Details of the procedure, including the specific artery involved (iliofemoral)
• Incision site and approach
• 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 code 35355, it is important to ensure that the procedure performed matches the description of the code. The iliofemoral artery must be the specific artery involved in the thromboendarterectomy. It is also essential to follow any additional guidelines provided by insurance payers or regulatory bodies regarding the use of this code. It is important to note that CPT code 35355 should not be reported with other codes unless specific circumstances warrant it.

8. Historical information

CPT code 35355 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been some changes to the code. On January 1, 2007, the description of the code was modified to include the possibility of a patch graft being performed. Additionally, in 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A healthcare provider performs a thromboendarterectomy on the iliofemoral artery of a patient with severe atherosclerosis.
2. A patient with a thrombus in their iliofemoral artery undergoes a thromboendarterectomy procedure to remove the obstruction.
3. A qualified healthcare provider performs a thromboendarterectomy on the iliofemoral artery of a patient with peripheral artery disease.
4. A patient with a history of thromboembolism undergoes a thromboendarterectomy on their iliofemoral artery to prevent further complications.
5. A healthcare provider performs a thromboendarterectomy on the iliofemoral artery of a patient with chronic venous insufficiency.
6. A patient with a thrombus in their iliofemoral artery undergoes a thromboendarterectomy procedure to restore normal blood flow.
7. A qualified healthcare provider performs a thromboendarterectomy on the iliofemoral artery of a patient with deep vein thrombosis.