How To Use CPT Code 35636

CPT 35636 describes a specific bypass graft procedure that involves using a synthetic graft to reroute the connection from the splenic artery to the renal artery. 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 35636?

CPT 35636 is a code that represents a bypass graft procedure using a synthetic graft to bypass a blockage in the renal artery. The provider reroutes the connection from the splenic artery to the renal artery, allowing blood to flow around the blocked area. This procedure is performed to restore proper blood flow to the kidneys and other structures supplied by the renal artery.

2. Official Description

The official description of CPT code 35636 is: ‘Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis).’ This code specifically refers to the bypass graft procedure that involves creating an anastomosis between the splenic artery and the renal artery using a synthetic graft.

3. Procedure

1. The provider begins by making an incision in the abdomen and extending it to the flank to access the splenic artery and locate the second anastomosis site on the renal artery.
2. After carefully dissecting around the intestines and pancreas, the provider clears the tissue between the target anastomosis sites.
3. Additional incisions may be made as necessary, and a tunnel is created between the two sites.
4. The provider prepares the synthetic graft and applies clamps to the splenic artery.
5. An opening is created between the clamps, and one end of the graft is sutured to the splenic artery.
6. The graft is then passed through the tunnel and clamps are applied to the renal artery.
7. An opening is made in the diseased renal artery, and the other end of the graft is attached beyond the blocked area.
8. Finally, the provider may perform an arteriography or use a Doppler probe to check the patency of the graft. The incision is closed in layers, and a drain may be placed.

4. Qualifying circumstances

CPT 35636 is used when a synthetic graft is used to bypass a blockage in the renal artery by creating an anastomosis between the splenic artery and the renal artery. This procedure is typically performed when other treatment options have been exhausted or are not suitable for the patient. It is important to note that this procedure is performed by a qualified healthcare professional and requires appropriate prepping and anesthesia.

5. When to use CPT code 35636

CPT code 35636 should be used when a provider performs a bypass graft procedure using a synthetic graft to reroute the connection from the splenic artery to the renal artery. This code is specific to the splenorenal bypass procedure and should not be used for other types of bypass grafts or procedures.

6. Documentation requirements

To support a claim for CPT 35636, the provider must document the following information:

• Patient’s diagnosis and the need for the bypass graft procedure
• Details of the procedure, including the specific vessels involved and the use of a synthetic graft
• Date of the procedure and any additional relevant information
• Any complications or additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 35636, ensure that the procedure meets the specific criteria outlined in the code description. It is important to use the appropriate code for the specific bypass graft procedure performed. Additionally, be aware of any Medicare changes or specific billing requirements that may apply to this code.

8. Historical information

CPT code 35636 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare billing purposes.

9. Examples

1. A patient with a blockage in the renal artery undergoes a splenorenal bypass graft procedure using a synthetic graft.
2. A provider performs a splenorenal bypass graft procedure on a patient with renal artery stenosis.
3. A synthetic graft is used to create an anastomosis between the splenic artery and the renal artery in a patient with renal artery occlusion.
4. A provider performs a splenorenal bypass graft procedure to restore blood flow to the kidneys in a patient with renal artery disease.
5. A patient with a blockage in the renal artery undergoes a splenorenal bypass graft procedure using a synthetic graft to improve renal function.
6. A provider performs a splenorenal bypass graft procedure on a patient with renal artery thrombosis.
7. A synthetic graft is used to bypass a blockage in the renal artery and restore blood flow to the kidneys in a patient with renal artery stenosis.
8. A provider performs a splenorenal bypass graft procedure to treat a patient with renal artery fibromuscular dysplasia.
9. A patient with a blockage in the renal artery undergoes a splenorenal bypass graft procedure using a synthetic graft to prevent further kidney damage.
10. A provider performs a splenorenal bypass graft procedure on a patient with renal artery atherosclerosis.