How To Use CPT Code 35521

CPT 35521 describes a procedure known as bypass graft, with vein, specifically connecting the axillary artery to a portion of the femoral artery using a vein graft. 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 35521?

CPT 35521 is a code used to describe a surgical procedure in which a bypass graft is performed using a vein to connect the axillary artery to a portion of the femoral artery. This procedure is typically done to bypass a blockage in the blood vessels and restore normal blood flow.

2. Official Description

The official description of CPT code 35521 is: ‘Bypass graft, with vein; axillary-femoral.’ This code specifically refers to the use of a vein graft to create a bypass between the axillary artery and a portion of the femoral artery.

3. Procedure

1. The surgeon begins by making an incision near the collarbone to access the axillary artery.
2. Next, an incision is made in the thigh to access the femoral artery.
3. The surgeon applies clamps to the axillary artery to temporarily stop blood flow.
4. An opening is created in the axillary artery, and one end of the vein graft is attached to this opening.
5. The surgeon then passes the vein graft through a created tunnel to reach the femoral artery.
6. Clamps are applied to the femoral artery, and an opening is made to attach the other end of the vein graft.
7. The surgeon removes the clamps to restore normal blood flow and ensures hemostasis before closing the incisions.

4. Qualifying circumstances

CPT 35521 is typically performed on patients who have a blockage in their blood vessels that requires bypass surgery. The procedure involves using a vein graft to create a bypass between the axillary artery and a portion of the femoral artery. It is important to note that this code specifically applies to procedures performed with a vein graft, and a different code should be used for procedures performed with a synthetic graft.

5. When to use CPT code 35521

CPT code 35521 should be used when a surgeon performs a bypass graft procedure using a vein to connect the axillary artery to a portion of the femoral artery. This code is specific to procedures performed with a vein graft and should not be used for procedures performed with a synthetic graft.

6. Documentation requirements

To support a claim for CPT 35521, the surgeon must document the following information:

• Patient’s diagnosis and the need for bypass graft surgery
• Details of the procedure, including the use of a vein graft and the specific arteries involved
• Date of the procedure
• Incision sites and closure techniques
• Confirmation of restored blood flow and hemostasis
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 35521, it is important to ensure that the procedure was performed using a vein graft to connect the axillary artery to a portion of the femoral artery. If a synthetic graft was used instead, a different code should be used. Additionally, it is important to follow any specific billing guidelines provided by insurance companies or payers.

8. Historical information

CPT code 35521 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. However, it is worth noting that in 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A surgeon performing a bypass graft procedure using a vein to connect the axillary artery to a portion of the femoral artery in a patient with peripheral artery disease.
2. A vascular surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s leg.
3. A cardiothoracic surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s arm.
4. A surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s foot.
5. A vascular surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s hand.
6. A surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s thigh.
7. A cardiothoracic surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s chest.
8. A vascular surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s abdomen.
9. A surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s pelvis.
10. A cardiothoracic surgeon performing a bypass graft procedure using a vein to bypass a blockage in the blood vessels of a patient’s neck.