How To Use CPT Code 35563

CPT 35563 describes the procedure for bypass grafting using a vein to connect the iliac arteries. 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 35563?

CPT 35563 can be used to describe the procedure of bypass grafting, specifically connecting the iliac arteries using a vein graft. This code is used when a healthcare provider performs the surgery to bypass a blockage in the blood vessels by inserting a graft that connects the iliac artery to another iliac artery using a vein.

2. Official Description

The official description of CPT code 35563 is: ‘Bypass graft, with vein; ilioiliac.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. An abdominal incision is made to access the iliac arteries.
3. A graft is harvested from another part of the body.
4. The provider applies clamps to the iliac arteries.
5. An opening is created and one end of the graft is attached to one iliac artery.
6. The graft is passed over to the other iliac artery, clamping vessels as necessary.
7. Another opening is created and the other end of the graft is attached to the second iliac artery.
8. The clamps are removed to restore normal blood flow.
9. The incision is closed in layers after ensuring hemostasis.

4. Qualifying circumstances

CPT 35563 is performed on patients who have a blockage in their blood vessels that requires bypass grafting. The procedure specifically involves connecting the iliac arteries using a vein graft. This surgery is typically performed by a healthcare provider who is trained and qualified to perform bypass graft procedures.

5. When to use CPT code 35563

CPT code 35563 should be used when a healthcare provider performs a bypass graft procedure that involves connecting the iliac arteries using a vein graft. This code is specific to the ilioiliac bypass graft procedure and should not be used for other types of bypass grafts or procedures.

6. Documentation requirements

To support a claim for CPT 35563, the healthcare provider must document the following information:

• Patient’s medical history and diagnosis necessitating the bypass graft procedure
• Details of the procedure, including the use of a vein graft and the connection of the iliac arteries
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 35563, ensure that the procedure performed matches the description of the code. It is important to accurately document the details of the procedure and any additional services provided. CPT code 35563 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT 35563 was added to the Current Procedural Terminology system on January 1, 1990. The code was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A healthcare provider performs an ilioiliac bypass graft procedure using a vein graft to bypass a blockage in the iliac arteries.
2. A patient with atherosclerosis undergoes an ilioiliac bypass graft surgery to restore blood flow in the iliac arteries.
3. A healthcare provider performs an ilioiliac bypass graft procedure using a vein graft to treat a patient with peripheral arterial disease.
4. An individual with a history of blood clots undergoes an ilioiliac bypass graft surgery to prevent further complications.
5. A patient with a blockage in the iliac arteries undergoes an ilioiliac bypass graft procedure using a vein graft to improve blood flow.
6. A healthcare provider performs an ilioiliac bypass graft surgery on a patient with a congenital vascular anomaly.
7. An individual with a history of failed angioplasty undergoes an ilioiliac bypass graft procedure using a vein graft.
8. A patient with atherosclerosis and severe leg pain undergoes an ilioiliac bypass graft surgery to alleviate symptoms.
9. A healthcare provider performs an ilioiliac bypass graft procedure using a vein graft to treat a patient with chronic limb ischemia.
10. An individual with a blockage in the iliac arteries undergoes an ilioiliac bypass graft surgery to improve blood flow and prevent complications.