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2025 CPT code 35184

Repair of a congenital arteriovenous fistula in the extremities.

Refer to the official CPT coding guidelines and any payer-specific guidelines for accurate coding and reimbursement.

Modifiers may apply depending on the circumstances of the procedure.Examples include modifiers for multiple procedures (51), reduced services (52), or assistant surgeon (80).

Medical necessity for surgical repair is established when the arteriovenous fistula causes symptoms such as pain, swelling, significant hypertrophy, high-output cardiac failure, or risk of rupture and hemorrhage.Documentation must support the clinical indication for the surgery.

The surgeon is responsible for performing the surgical repair, including incision, isolation of the fistula, division of the abnormal connection, repair of the vessels (with sutures or graft if needed), verification of restored blood flow, and closure of the incision.

IMPORTANT:Use 35182 for repair of a congenital arteriovenous fistula in the abdomen or thorax.35189 and 35190 are used for acquired arteriovenous fistulas.

In simple words: The doctor surgically repairs an abnormal connection between an artery and vein in an arm or leg that was present since birth. This involves making an incision, closing the abnormal connection, and repairing the vessels to restore normal blood flow.

This procedure involves surgical repair of a congenital arteriovenous fistula located in the extremities.The surgeon makes an incision to access the fistula, applies clamps to isolate it, and then severs the abnormal connection between the artery and vein.Individual vessels are repaired using sutures or a graft material as needed.The surgeon verifies the restoration of normal blood flow using a Doppler probe, and closes the incision in layers to prevent hematoma formation.

Example 1: A 25-year-old patient presents with a congenital arteriovenous fistula in the forearm causing pain, swelling, and a palpable thrill.Surgical repair is indicated., A 10-year-old child with a large congenital arteriovenous fistula in the leg experiencing significant hypertrophy and growth distortion undergoes surgical correction., An adult patient with a high-flow congenital arteriovenous fistula in the upper extremity that has caused significant heart strain requires surgical intervention to reduce blood flow.

Preoperative assessment, including imaging (e.g., ultrasound, angiography) to delineate the fistula anatomy, operative report detailing the surgical technique, intraoperative findings (e.g., size of fistula, vessel repair methods), postoperative assessment of blood flow and wound healing, and any complications encountered.

** Always refer to the most recent CPT codebook and payer guidelines for the most current information.

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