How To Use CPT Code 35634

CPT 35634 describes a specific bypass graft procedure that involves the use of a synthetic graft to bypass a blockage in the renal artery. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35634?

CPT 35634 is a code used to describe a bypass graft procedure that involves the use of a synthetic graft to reroute the connection from the iliac artery to bypass a blockage in the renal artery. This procedure is performed by a healthcare provider to restore blood flow to the kidneys and improve overall renal function.

2. Official Description

The official description of CPT code 35634 is: ‘Bypass graft, with other than vein; iliorenal.’ This code should not be reported in conjunction with codes 35221, 35251, 35281, 35560, 35536, or 35631. It is important to note that CPT code 35634 was added to the Current Procedural Terminology system on January 1, 2009.

3. Procedure

1. The healthcare provider begins by making an incision in the abdomen to access the iliac artery and locate the second anastomosis site on the renal artery.
2. They then clear the tissue between the target anastomosis sites and create a tunnel if necessary.
3. The provider prepares the synthetic graft and applies clamps to the iliac artery.
4. They suture one end of the graft to the iliac artery and pass the graft through the tunnel.
5. Clamps are then applied to the renal artery, and an opening is created in the diseased renal artery.
6. The other end of the graft is attached to the artery beyond the blocked area.
7. Finally, the provider may perform an arteriography or ultrasound to check the patency of the graft, and the incision is closed in layers.

4. Qualifying circumstances

CPT 35634 is typically performed on patients with severe hypertension and renal insufficiency who are at high risk for direct aorta to renal bypass surgery. The procedure is considered nonanatomic and is used as an alternative method for bypassing a blockage in the renal artery. It is important to note that CPT code 35634 should not be reported in conjunction with codes 35221, 35251, 35281, 35560, 35536, or 35631.

5. When to use CPT code 35634

CPT code 35634 should be used when a healthcare provider performs a bypass graft procedure using a synthetic graft to bypass a blockage in the renal artery. This code should not be used in conjunction with certain other codes, as mentioned in the official description.

6. Documentation requirements

To support a claim for CPT code 35634, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the bypass graft procedure
• Details of the procedure, including the use of a synthetic graft and the specific sites of anastomosis
• Date of the procedure
• Any additional procedures performed, such as arteriography or ultrasound
• Details of the closure of the incision
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 35634, it is important to ensure that the procedure meets the specific criteria outlined in the official description. Additionally, this code should not be reported in conjunction with codes 35221, 35251, 35281, 35560, 35536, or 35631. It is also important to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT code 35634 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates or changes to the code since its addition. It is important to stay updated on any changes or revisions to coding guidelines and requirements.

9. Examples

1. A healthcare provider performs a bypass graft procedure using a synthetic graft to bypass a blockage in the renal artery for a patient with severe hypertension and renal insufficiency.
2. During the procedure, the provider carefully sutures one end of the graft to the iliac artery and attaches the other end to the renal artery beyond the blocked area.
3. After the procedure, an arteriography is performed to ensure the patency of the graft.
4. The incision is closed in layers, and the patient is monitored for any post-operative complications.
5. Another healthcare provider performs a similar bypass graft procedure using a synthetic graft to bypass a blockage in the renal artery for a different patient with severe hypertension and renal insufficiency.
6. The procedure is successful in restoring blood flow to the kidneys and improving renal function in both patients.
7. Both procedures are documented and coded using CPT code 35634.
8. The healthcare providers ensure that the documentation supports the medical necessity and appropriateness of the procedure.
9. The claims are submitted to the insurance company for reimbursement.
10. The insurance company reviews the claims and processes the reimbursement based on the coding and documentation provided.