How To Use CPT Code 35700

CPT 35700 describes the reoperation on the femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than one month after the original operation. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35700?

CPT 35700 is used to report the reoperation on the femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than one month after the initial procedure. This code is used when the provider needs to perform additional work to repair or replace a graft that bypasses around a damaged or obstructed portion of an artery.

2. Official Description

The official description of CPT code 35700 is: ‘Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other specific codes for the primary procedure.

3. Procedure

1. The provider performs an arteriography to assess the location and extent of the occlusion.
2. The patient is appropriately prepped and anesthetized.
3. The provider makes an incision over the location of the affected arteries to access and expose them, as well as the previously placed graft.
4. The provider carefully avoids injuring any branches from the femoral artery.
5. The provider incises the artery above the point of the graft attachment and inserts a balloon catheter to open a narrowing in the graft or to straighten it.
6. If the graft requires replacement, the provider incises and reconstructs it, either by replacing the entire construct or suturing the ends of a new graft to the sides of the artery.
7. After completing the procedure, the provider removes all clamps and instrumentation, checks for bleeding, and closes the incisions in layers.

4. Qualifying circumstances

CPT 35700 is used when the provider needs to reoperate on a femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels more than one month after the original operation. This may be necessary to open a stricture in a graft or to replace the graft that bypasses around a damaged or obstructed portion of an artery.

5. When to use CPT code 35700

CPT code 35700 should be used when the provider needs to perform a reoperation on the femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels more than one month after the initial procedure. It should be reported in addition to the code for the primary procedure.

6. Documentation requirements

To support a claim for CPT 35700, the provider must document the following information:

• Date of the reoperation
• Specific arteries or vessels involved
• Reason for the reoperation
• Details of the procedure performed
• Any complications encountered
• Signature of the provider

7. Billing guidelines

When billing for CPT 35700, ensure that the reoperation occurs more than 30 days after the original bypass procedure. It is important to use this code in conjunction with other specific codes for the primary procedure. Carefully review the explanation of benefits (EOB) to ensure proper reimbursement for add-on codes. Reduction in reimbursement for add-on codes should only occur if specified in the provider’s contract.

8. Historical information

CPT 35700 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition. However, it was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes a reoperation on the femoral-popliteal artery one month after the initial bypass procedure to repair a stricture in the graft.
2. The provider performs a reoperation on the posterior tibial artery more than one month after the original operation to replace a damaged graft.
3. A patient requires a reoperation on the peroneal artery to open a narrowing in the graft, which was placed during the initial procedure.
4. The provider performs a reoperation on other distal vessels to reconstruct a graft that bypasses around an obstructed portion of an artery.
5. A patient undergoes a reoperation on the femoral-popliteal artery to replace a failed synthetic bypass graft, which was placed during the previous surgery.