How To Use CPT Code 35637

CPT 35637 describes a specific bypass graft procedure that involves the use of a synthetic graft to bypass a blockage in the iliac 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 35637?

CPT 35637 is a code used to describe a bypass graft procedure that involves the use of a synthetic graft to bypass a blockage in the iliac artery. This procedure reroutes the connection from the aorta around the blocked area of the iliac artery, allowing for improved blood flow.

2. Official Description

The official description of CPT code 35637 is: ‘Bypass graft, with other than vein; aortoiliac.’ This code should not be reported in conjunction with codes 35638 and 35646.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. An incision is made in the abdomen, and the provider accesses the iliac artery and locates the second anastomosis site on the abdominal aorta.
3. The provider separates muscle and tissue to visualize and check the underlying organs for signs of disease.
4. Tissue between the target anastomosis sites is cleared, and additional incisions may be made as necessary.
5. A tunnel is created between the two sites.
6. The graft is prepared.
7. Clamps are applied to the abdominal aorta, and an opening is created between the clamps.
8. One end of the synthetic graft is sutured to the aorta.
9. The graft is passed through the tunnel and clamps are applied to the iliac artery.
10. An opening is created in the diseased iliac artery, and the other end of the graft is attached to the artery beyond the blocked area.
11. The clamps are released, and the provider checks for leaks.
12. The patency of the graft may be checked through arteriography or ultrasound.
13. The incision is closed in layers, and a drain may be placed if necessary.

4. Qualifying circumstances

CPT 35637 is used when a synthetic graft is used to bypass a blockage in the iliac artery. This procedure is typically performed on patients with atherosclerosis or other conditions that cause narrowing or blockage of the iliac artery. It is important to note that CPT code 35637 should not be reported in conjunction with codes 35638 and 35646.

5. When to use CPT code 35637

CPT code 35637 should be used when a provider performs a bypass graft procedure using a synthetic graft to bypass a blockage in the iliac artery. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT code 35637, the 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 during the same session
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 35637, it is important to ensure that the procedure meets the specific criteria outlined in the official description. This code should not be reported in conjunction with codes 35638 and 35646. It is also important to follow any additional billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 35637 was added to the Current Procedural Terminology system on January 1, 2007. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with atherosclerosis undergoes a bypass graft procedure using a synthetic graft to bypass a blockage in the iliac artery.
2. A provider performs a bypass graft procedure on a patient with a history of peripheral artery disease, using a synthetic graft to bypass a blockage in the iliac artery.
3. A patient with a narrowing of the iliac artery due to atherosclerosis undergoes a bypass graft procedure using a synthetic graft.
4. A provider performs a bypass graft procedure on a patient with a blockage in the iliac artery, using a synthetic graft to restore blood flow.
5. A patient with a history of vascular disease undergoes a bypass graft procedure to bypass a blockage in the iliac artery using a synthetic graft.
6. A provider performs a bypass graft procedure on a patient with atherosclerosis, using a synthetic graft to bypass a blockage in the iliac artery.
7. A patient with a narrowing of the iliac artery undergoes a bypass graft procedure using a synthetic graft to restore blood flow.
8. A provider performs a bypass graft procedure on a patient with a blockage in the iliac artery, using a synthetic graft to bypass the obstruction.
9. A patient with a history of peripheral artery disease undergoes a bypass graft procedure to bypass a blockage in the iliac artery using a synthetic graft.
10. A provider performs a bypass graft procedure on a patient with atherosclerosis, using a synthetic graft to bypass a blockage in the iliac artery and restore blood flow.