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2025 CPT code 35189

Repair of acquired or traumatic arteriovenous fistula in the thorax or abdomen.

Ensure accurate coding based on the location and nature of the AVF. Do not report separately for the arteriogram performed by the surgeon if it is part of the procedure.

Modifiers may be applicable to indicate increased procedural services (22), multiple procedures (51), reduced services (52), distinct procedural service (59), two surgeons (62), and other specific circumstances.

Medical necessity must be established by documenting the symptoms, diagnostic findings, and the impact of the AVF on the patient's health. This may include evidence of circulatory compromise, pain, swelling, or other complications resulting from the fistula.

The surgeon is responsible for all aspects of the procedure, from preoperative planning and patient preparation to performing the surgery and postoperative care.

IMPORTANT:For congenital arteriovenous fistulas, use 35182.

In simple words: This procedure fixes an abnormal connection between an artery and a vein in your chest or belly area that happened due to an injury or other medical issue, not something you were born with. The surgeon makes a cut to reach the area, closes off the vessels, separates the artery and vein, and fixes them with stitches or a patch. They then check that the blood is flowing correctly and close the incision.

This code describes a surgical procedure to repair an acquired or traumatic arteriovenous fistula (AVF) located in the thorax or abdomen.The procedure involves making an incision to access the fistula, clamping the affected vessels, separating the abnormal connection between the artery and vein, and repairing each vessel with sutures or a graft.The surgeon confirms proper blood flow after the repair, often using Doppler ultrasound. The incision is then closed in layers.

Example 1: A patient presents with an acquired AVF in the chest following trauma.The AVF is causing circulatory issues, and surgical repair using code 35189 is performed., A patient on hemodialysis develops a traumatic AVF in their upper arm near the dialysis access site. The fistula is repaired using 35189., A patient develops an AVF in the abdomen following a previous surgery. Code 35189 is used to describe the repair of the fistula.

Documentation should include the location and size of the AVF, the operative approach, the method of repair (suture, graft), confirmation of restored blood flow (e.g., Doppler findings), and any complications encountered.Preoperative imaging studies and medical necessity justification should also be included.

** As of December 1st, 2024, this information reflects the current understanding of CPT code 35189.Always verify coding guidelines and fee schedules with official resources and payers.Consider using specialized coding software or consulting with a certified coder for complex cases.

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