How To Use CPT Code 35363

CPT 35363 describes the procedure known as thromboendarterectomy, specifically for the combined aortoiliofemoral artery. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35363?

CPT 35363 is a code used to describe a surgical procedure called thromboendarterectomy. This procedure involves the removal of thrombus and plaques from the combined aortoiliofemoral artery. It is typically performed to restore normal blood flow and prevent further complications in patients with arterial blockages in this specific area.

2. Official Description

The official description of CPT code 35363 is: ‘Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral.’

3. Procedure

1. The surgeon begins by making incisions in the abdomen and groin to access the aorta, iliac, and femoral arteries.
2. If necessary, a vein graft may be harvested from the patient’s own body to be used as a patch graft.
3. Vascular clamps are placed as needed to isolate the aortoiliofemoral artery.
4. The surgeon then performs an endarterectomy, which involves removing the thrombus or atherosclerosis from the affected portion of the artery.
5. If a patch graft is required, it is placed over the opened artery to cover the defect.
6. The arterial opening is closed with sutures, and the clamps are removed to restore normal blood flow.
7. The incisions in the skin are closed in layers, ensuring hemostasis.

4. Qualifying circumstances

CPT 35363 is used for patients who require thromboendarterectomy specifically in the combined aortoiliofemoral artery. This procedure is typically performed on patients with arterial blockages or thrombus formation in this specific area. It is important to note that the use of a patch graft is optional and may or may not be performed during the procedure.

5. When to use CPT code 35363

CPT code 35363 should be used when a surgeon performs a thromboendarterectomy procedure on the combined aortoiliofemoral artery. It is important to ensure that the procedure is performed specifically in this artery and not in other arterial locations. If the procedure is performed in a different artery, a different CPT code should be used to accurately describe the procedure.

6. Documentation requirements

To support a claim for CPT 35363, the surgeon must document the following information:

• Patient’s diagnosis and indication for the thromboendarterectomy procedure
• Details of the procedure, including the use of a patch graft if performed
• Date of the procedure
• Incision sites and approach used
• Specific arteries involved (aorta, iliac, femoral)
• Any complications or additional procedures performed
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 35363, it is important to ensure that the procedure is performed specifically on the combined aortoiliofemoral artery. The use of a patch graft, if performed, should be documented and coded accordingly. It is also important to follow any specific billing guidelines provided by insurance carriers or Medicare to ensure accurate reimbursement for the procedure.

8. Historical information

CPT 35363 was added to the Current Procedural Terminology system on January 1, 1990. There have been some changes to the code over the years, 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 billing purposes.

9. Examples

1. A surgeon performs a thromboendarterectomy on the combined aortoiliofemoral artery to remove thrombus and plaques, restoring normal blood flow.
2. A patient with arterial blockages in the combined aortoiliofemoral artery undergoes a thromboendarterectomy procedure with the use of a patch graft.
3. A surgeon performs a thromboendarterectomy specifically on the combined aortoiliofemoral artery, without the need for a patch graft.
4. A patient with a history of arterial thrombosis in the combined aortoiliofemoral artery undergoes a thromboendarterectomy procedure to prevent further complications.
5. A surgeon performs a thromboendarterectomy on the combined aortoiliofemoral artery, using a synthetic patch graft to cover the defect.
6. A patient with atherosclerosis in the combined aortoiliofemoral artery undergoes a thromboendarterectomy procedure to remove the plaque and restore normal blood flow.
7. A surgeon performs a thromboendarterectomy on the combined aortoiliofemoral artery, using a vein graft as a patch to cover the defect.
8. A patient with arterial blockages in the combined aortoiliofemoral artery undergoes a thromboendarterectomy procedure, resulting in improved blood flow and reduced symptoms.
9. A surgeon performs a thromboendarterectomy on the combined aortoiliofemoral artery, documenting the procedure details and any complications encountered.
10. A patient with a history of thrombus formation in the combined aortoiliofemoral artery undergoes a thromboendarterectomy procedure to prevent further complications and improve blood flow.