How To Use CPT Code 35665

CPT 35665 describes a procedure known as iliofemoral bypass graft, which involves using a synthetic graft to bypass a blockage in the iliac artery by rerouting the connection around the blockage to the femoral 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 35665?

CPT 35665 is a code used to describe a specific procedure in which a synthetic graft is used to bypass a blockage in the iliac artery. The graft is connected from the iliac artery in the abdomen to the femoral artery in the upper thigh, allowing blood to flow around the blockage and restore proper circulation. This procedure is typically performed to treat unilateral iliac atherosclerotic disease.

2. Official Description

The official description of CPT code 35665 is: ‘Bypass graft, with other than vein; iliofemoral.’

3. Procedure

1. The provider begins by making incisions in the patient’s skin over the iliac artery in the abdomen and the femoral artery in the upper thigh.
2. A synthetic graft is prepared to be used in the bypass procedure.
3. The provider applies clamps to the affected iliac artery and ligates or incises the diseased artery beyond the blockage.
4. One end of the synthetic graft is attached to the iliac artery, and the graft is passed through a tunnel created in the upper thigh.
5. The provider applies clamps to the femoral artery and creates an opening in the artery to attach the other end of the graft.
6. The graft is attached in an end-to-side or side-to-side manner.
7. The clamps are released, and the provider checks for any leaks.
8. If necessary, the patency of the graft may be checked through arteriography or ultrasound.
9. The incisions are closed in layers, and a drain may be placed.

4. Qualifying circumstances

CPT 35665 is typically performed on patients with unilateral iliac atherosclerotic disease, where the iliac artery is blocked or severely narrowed. The procedure involves the use of a synthetic graft to bypass the blockage and restore blood flow. It is important to note that this code specifically refers to bypass graft procedures using a synthetic graft other than a vein.

5. When to use CPT code 35665

CPT code 35665 should be used when a provider performs an iliofemoral bypass graft using a synthetic graft other than a vein. This procedure is indicated for patients with unilateral iliac atherosclerotic disease and is performed to restore blood flow and alleviate symptoms caused by the blockage. It is important to accurately document the medical necessity and details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 35665, the provider must document the following information:

• Diagnosis of unilateral iliac atherosclerotic disease
• Details of the procedure, including the use of a synthetic graft and the specific vessels involved
• Date of the procedure
• Start and end times of the procedure
• Any additional procedures performed, such as arteriography or ultrasound
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 35665, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of a synthetic graft other than a vein and the bypass of the iliac artery to the femoral artery must be documented. It is also important to follow any additional guidelines provided by payers or coding authorities. It is recommended to review the specific billing guidelines for CPT code 35665 to ensure accurate reporting and reimbursement.

8. Historical information

CPT code 35665 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates or changes since its addition. However, it is important to stay updated with any changes or revisions to coding guidelines and regulations.

9. Examples

1. A patient with unilateral iliac atherosclerotic disease undergoes an iliofemoral bypass graft using a synthetic graft other than a vein.
2. A provider performs an iliofemoral bypass graft procedure on a patient with a blocked iliac artery, using a synthetic graft to restore blood flow.
3. An individual with severe narrowing of the iliac artery undergoes an iliofemoral bypass graft to alleviate symptoms and improve circulation.
4. A provider performs an iliofemoral bypass graft using a synthetic graft on a patient with unilateral iliac artery blockage caused by atherosclerosis.
5. A synthetic graft is used in an iliofemoral bypass graft procedure to bypass a blockage in the iliac artery and restore blood flow in a patient with unilateral iliac atherosclerotic disease.
6. A provider performs an iliofemoral bypass graft using a synthetic graft to bypass a blockage in the iliac artery and improve blood flow in a patient with unilateral iliac artery disease.
7. An iliofemoral bypass graft procedure is performed on a patient with unilateral iliac atherosclerotic disease, using a synthetic graft to bypass the blockage and restore proper circulation.
8. A provider performs an iliofemoral bypass graft using a synthetic graft to bypass a blockage in the iliac artery and improve blood flow in a patient with unilateral iliac artery stenosis.
9. An individual with unilateral iliac artery blockage undergoes an iliofemoral bypass graft procedure using a synthetic graft to restore blood flow and alleviate symptoms.