How To Use CPT Code 35820

CPT 35820 describes the exploration for postoperative hemorrhage, thrombosis, or infection in the chest. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35820?

CPT 35820 can be used to describe the exploration procedure performed by a healthcare provider to identify and address postoperative issues such as hemorrhage, thrombosis, or infection in the chest. This code is used when the provider reopens the patient’s chest to locate and correct the source of the problem after a previous operation.

2. Official Description

The official description of CPT code 35820 is: ‘Exploration for postoperative hemorrhage, thrombosis or infection; chest.’

3. Procedure

1. The provider prepares and anesthetizes the patient for the procedure.
2. An incision is made in the patient’s chest over the area of concern.
3. The provider carefully dissects down, preserving underlying vessels and structures.
4. The site of hemorrhage, thrombosis, or infection related to blood vessels is examined.
5. The provider controls the source of bleeding, removes thrombus, or addresses the area of infection.
6. If there is hemorrhage, the provider locates the bleeding vessel and applies clamps, cauterizes, ligates, or sutures it.
7. Additional areas of bleeding near or related to the previous surgery are checked.
8. If a thrombosis is found, the provider incises the vessel and removes the blood clot.
9. In case of infection, the provider drains the area and may place a drain for ongoing fluid removal.
10. The provider ensures normal blood flow in repaired vessels, irrigates the area, and closes the surgical wound.

4. Qualifying circumstances

Patients who may require CPT 35820 are those who have undergone a previous operation and experience postoperative issues such as hemorrhage, thrombosis, or infection in the chest. The provider must reopen the chest to explore and address the source of the problem. This code is specific to the circulatory system and focuses on managing hemorrhage via blood vessels.

5. When to use CPT code 35820

CPT code 35820 should be used when a provider needs to explore the chest to identify and address postoperative hemorrhage, thrombosis, or infection. It should not be used for bleeding that occurs during the initial operative session. Other codes, such as 35800 to 35860, should be used for that purpose.

6. Documentation requirements

To support a claim for CPT 35820, the provider must document the following information:

• Patient’s diagnosis and indication for exploration
• Details of the procedure, including the specific areas explored and any interventions performed
• Date and duration of the procedure
• Any complications encountered and their management
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 35820, ensure that the procedure meets the criteria for exploration of postoperative hemorrhage, thrombosis, or infection in the chest. Consider using modifier 78, Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period, if applicable. Review the specific billing guidelines provided by payers to ensure accurate reporting.

8. Historical information

CPT 35820 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes cardiac surgery and experiences postoperative bleeding in the chest. The provider performs CPT 35820 to explore and address the source of the hemorrhage.
2. Following a thoracic surgery, a patient develops an infection in the chest. The provider reopens the chest and performs CPT 35820 to explore and drain the infected area.
3. After a vascular procedure, a patient develops a thrombosis in a chest vessel. The provider performs CPT 35820 to explore and remove the blood clot.
4. A patient undergoes a chest surgery and experiences postoperative bleeding near the surgical site. The provider performs CPT 35820 to explore and control the bleeding.
5. Following a previous operation, a patient develops an infection in the chest. The provider performs CPT 35820 to explore, drain, and manage the infection.
6. After a cardiac procedure, a patient experiences postoperative hemorrhage in the chest. The provider performs CPT 35820 to explore and address the source of the bleeding.
7. A patient undergoes a thoracic surgery and develops a thrombosis in a chest vessel. The provider performs CPT 35820 to explore and remove the blood clot.
8. Following a vascular procedure, a patient experiences postoperative bleeding near the surgical site. The provider performs CPT 35820 to explore and control the bleeding.
9. After a previous operation, a patient develops an infection in the chest. The provider performs CPT 35820 to explore, drain, and manage the infection.
10. A patient undergoes a chest surgery and experiences postoperative hemorrhage in the chest. The provider performs CPT 35820 to explore and address the source of the bleeding.