How To Use CPT Code 35500

CPT 35500 describes the procedure of harvesting a vein from the upper extremity for use in a lower extremity or coronary artery bypass 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 35500?

CPT 35500 involves the removal of a vein from the upper extremity to be used as a graft in a separate bypass procedure on a lower extremity or coronary artery. This code is used when the provider makes an incision over the vein, dissects the soft tissue, ties off and divides side branches, ligates the area to be harvested, and removes the section of the vein. The harvested vein is then prepared for grafting by flushing it with saline, testing for leaks, and repairing any leaks if necessary. The incision at the harvest site is closed with sutures and dressed.

2. Official Description

The official description of CPT code 35500 is: ‘Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the appropriate primary procedure codes for the bypass procedure.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a long incision over the vein to be harvested.
3. Soft tissue is dissected as needed to reach the vein.
4. Side branches are tied off and divided.
5. The area to be harvested is ligated at each end and the section of the vein is cut out.
6. The harvested vein is prepared by flushing it with saline, testing for leaks, and repairing any leaks if necessary.
7. The incision at the harvest site is closed with sutures and the wound is dressed.

4. Qualifying circumstances

CPT 35500 is used when a vein from the upper extremity is harvested for use in a lower extremity or coronary artery bypass procedure. This procedure is typically performed during the same session as the bypass procedure. It is important to note that CPT 35500 should be reported in addition to the primary procedure code for the bypass procedure.

5. When to use CPT code 35500

CPT code 35500 should be used when a provider harvests a vein from the upper extremity for use in a separate bypass procedure on a lower extremity or coronary artery. It is important to report this code in addition to the primary procedure code for the bypass procedure.

6. Documentation requirements

To support a claim for CPT 35500, the provider must document the following information:

• Indication for the harvest of the vein
• Details of the procedure, including the incision, dissection, ligation, and removal of the vein
• Preparation of the harvested vein for grafting
• Closure of the harvest site incision

7. Billing guidelines

When billing for CPT 35500, it is important to ensure that the procedure is performed during the same session as the bypass procedure. This code should be reported in addition to the primary procedure code for the bypass. Payers may not reimburse for CPT 35500 if it is reported without an appropriate primary code. It is also important to note that CPT 35500 is an add-on code and should not be reported alone.

8. Historical information

CPT 35500 was added to the Current Procedural Terminology system on January 1, 1999. There have been no updates to the code since its addition.

9. Examples

1. A provider harvests a vein from the upper extremity to be used in a bypass procedure on the lower extremity.
2. A surgeon makes an incision over the vein, dissects the soft tissue, and ligates the area to be harvested before removing the section of the vein.
3. A patient undergoes a bypass procedure on the coronary artery, and a vein from the upper extremity is harvested for grafting.
4. A provider prepares a harvested vein by flushing it with saline, testing for leaks, and repairing any leaks if necessary.
5. A surgeon closes the incision at the harvest site with sutures and dresses the wound.
6. A patient receives a bypass procedure on the lower extremity, and a vein from the upper extremity is harvested for use as a graft.
7. A provider ties off and divides side branches of the vein before ligating the area to be harvested and removing the section of the vein.
8. A surgeon performs a bypass procedure on the coronary artery, using a vein harvested from the upper extremity.
9. A patient undergoes a bypass procedure on the lower extremity, and a vein from the upper extremity is harvested for grafting.
10. A provider prepares the harvested vein by flushing it with saline, testing for leaks, and repairing any leaks if necessary.