How To Use CPT Code 35682

CPT 35682 describes the creation of a composite graft using two segments of veins from two different locations in the patient’s body. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35682?

CPT 35682 can be used to describe the procedure in which a provider creates a composite graft, or conduit, using two segments of veins harvested from two different locations in the patient’s body. This graft is then used as a bypass graft to restore blood flow in a blocked or severely narrowed vessel.

2. Official Description

The official description of CPT code 35682 is: ‘Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the primary procedure code for graft placement.

3. Procedure

1. To perform CPT 35682, the provider begins by harvesting two segments of veins from different locations in the patient’s body.
2. The provider then constructs a composite graft by suturing the two vein segments together using fine sutures.
3. The graft is tested for patency, and additional sutures may be added if necessary.
4. The composite graft is then used as a bypass graft in a separately reportable bypass procedure to restore blood flow in a blocked or narrowed vessel.

4. Qualifying circumstances

CPT 35682 is used when a provider needs to create a composite graft using two segments of veins from two different locations in the patient’s body. This procedure is typically performed when the provider cannot harvest a sufficient length of autogenous vein from a single location for a venous tissue bypass. It may also be used when the vein is unsuitable due to anatomical reasons or sclerosis.

5. When to use CPT code 35682

CPT code 35682 should be used when a provider performs the procedure to create a composite graft using two segments of veins from two different locations in the patient’s body. It should be reported in conjunction with the primary code for graft placement.

6. Documentation requirements

To support a claim for CPT 35682, the provider must document the following information:

• Details of the procedure, including the locations from which the vein segments were harvested
• Description of the composite graft construction process
• Testing of the graft for patency
• Any additional sutures added to the graft
• Documentation of the separately reportable bypass procedure in which the composite graft was used

7. Billing guidelines

When billing for CPT 35682, ensure that the procedure meets the qualifying circumstances and is performed as described in the official description. Report CPT 35682 in addition to the primary procedure code for graft placement. Do not report CPT 35682 in addition to CPT 35681 or CPT 35683.

8. Historical information

CPT 35682 was added to the Current Procedural Terminology system on January 1, 1999. The code underwent a change on January 1, 2010, with an updated description. It was also added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider harvests segments of veins from the patient’s leg and arm to create a composite graft. The graft is then used as a bypass graft in a separately reportable bypass procedure to restore blood flow in a blocked coronary artery.
2. During a lower extremity bypass procedure, a provider harvests two segments of veins from different locations in the patient’s leg. The composite graft is then used to bypass a severely narrowed femoral artery.
3. A patient with a blocked carotid artery undergoes a bypass procedure. The provider creates a composite graft using two segments of veins from the patient’s arm and leg. The graft is used to restore blood flow in the carotid artery.
4. For a patient with peripheral artery disease, a provider constructs a composite graft using two segments of veins harvested from the patient’s leg and arm. The graft is then used to bypass a blocked popliteal artery.
5. During a coronary artery bypass graft surgery, a provider creates a composite graft using two segments of veins from different locations in the patient’s body. The graft is used to bypass blocked coronary arteries and restore blood flow to the heart.
6. A patient with a blocked femoral artery undergoes a bypass procedure. The provider constructs a composite graft using two segments of veins harvested from the patient’s leg and arm. The graft is used to bypass the blocked artery and restore blood flow.
7. During a lower extremity bypass surgery, a provider creates a composite graft using two segments of veins from different locations in the patient’s body. The graft is used to bypass a severely narrowed tibial artery and restore blood flow to the patient’s foot.
8. A patient with a blocked renal artery undergoes a bypass procedure. The provider constructs a composite graft using two segments of veins harvested from the patient’s leg and arm. The graft is used to bypass the blocked artery and restore blood flow to the kidney.
9. For a patient with a blocked iliac artery, a provider creates a composite graft using two segments of veins from different locations in the patient’s body. The graft is used to bypass the blocked artery and restore blood flow to the patient’s pelvis and lower extremities.
10. During a bypass surgery for a blocked brachial artery, a provider constructs a composite graft using two segments of veins harvested from the patient’s arm and leg. The graft is used to bypass the blocked artery and restore blood flow to the patient’s arm.