How To Use CPT Code 35523

CPT 35523 describes a procedure known as bypass graft, specifically involving the brachial artery and either the ulnar or radial 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 35523?

CPT 35523 is a code used to describe a bypass graft procedure that involves connecting the brachial artery to either the ulnar or radial artery using a vein graft. This procedure is performed to bypass a blockage in a blood vessel and restore normal blood flow. It is important to note that CPT 35523 should not be reported in conjunction with codes 35206, 35500, 35525, or 36838, and for bypass grafts performed with synthetic conduit, code 37799 should be used instead.

2. Official Description

The official description of CPT code 35523 is: ‘Bypass graft, with vein; brachial-ulnar or -radial.’

3. Procedure

1. The provider begins by making an incision in the arm and accessing the brachial artery.
2. Clamps are applied to the brachial artery to temporarily stop blood flow.
3. An opening is created in the artery, and one end of the vein graft is attached to it.
4. The graft is then passed through a created tunnel and clamps are applied to either the ulnar or radial artery.
5. Another opening is created in the chosen artery, and the other end of the graft is attached to it.
6. The clamps are removed to restore normal blood flow, and the incision in the arm is closed in layers.

4. Qualifying circumstances

CPT 35523 is performed when there is a blockage in a blood vessel that requires bypassing. The procedure involves connecting the brachial artery to either the ulnar or radial artery using a vein graft. It is important to note that CPT 35523 should not be reported in conjunction with codes 35206, 35500, 35525, or 36838, and for bypass grafts performed with synthetic conduit, code 37799 should be used instead.

5. When to use CPT code 35523

CPT code 35523 should be used when a bypass graft procedure is performed, specifically involving the brachial artery and either the ulnar or radial artery, using a vein graft. It is important to follow the guidelines and not report this code with other specified codes or when a synthetic conduit is used for the graft.

6. Documentation requirements

To support a claim for CPT 35523, the provider must document the following information:

• Patient’s diagnosis and the need for a bypass graft procedure
• Specific details of the procedure, including the use of a vein graft and the connection between the brachial artery and either the ulnar or radial artery
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 35523, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that CPT 35523 should not be reported in conjunction with codes 35206, 35500, 35525, or 36838, and for bypass grafts performed with synthetic conduit, code 37799 should be used instead. Pay attention to any additional guidelines or restrictions provided by payers or insurance companies.

8. Historical information

CPT 35523 was added to the Current Procedural Terminology system on January 1, 2008. It has not undergone any updates since its addition. Additionally, it is important to note that CPT 35523 is listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a bypass graft procedure to connect the brachial artery to the ulnar artery using a vein graft.
2. A provider performs a bypass graft procedure, connecting the brachial artery to the radial artery using a vein graft.
3. During a bypass graft procedure, the provider connects the brachial artery to the ulnar artery using a vein graft to bypass a blockage.
4. A patient with a blood vessel blockage undergoes a bypass graft procedure, connecting the brachial artery to the radial artery using a vein graft.
5. A provider performs a bypass graft procedure, connecting the brachial artery to the ulnar artery using a vein graft to restore normal blood flow.
6. During a bypass graft procedure, the provider connects the brachial artery to the radial artery using a vein graft to bypass a blockage and improve blood flow.
7. A patient undergoes a bypass graft procedure to connect the brachial artery to the ulnar artery using a vein graft to treat a blood vessel blockage.
8. A provider performs a bypass graft procedure, connecting the brachial artery to the radial artery using a vein graft to restore proper blood flow.
9. During a bypass graft procedure, the provider connects the brachial artery to the ulnar artery using a vein graft to bypass a blockage and improve circulation.
10. A patient with a blood vessel blockage undergoes a bypass graft procedure, connecting the brachial artery to the radial artery using a vein graft to restore normal blood flow.