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2025 CPT code 35236

Repair of an injured blood vessel in an upper extremity using a vein graft.

Follow current CPT coding guidelines for vascular surgery.Accurate documentation is crucial for proper coding and reimbursement.

Modifiers may be applicable depending on circumstances.Consult the CPT manual and NCCI edits for appropriate modifier usage (e.g., 51 for multiple procedures, 59 for distinct procedural services).

Medical necessity is established when the patient presents with symptoms consistent with compromised circulation in the upper extremity due to vascular injury or disease.Repair with a vein graft is medically necessary to restore adequate blood flow and prevent complications such as limb loss or tissue necrosis. Supporting documentation must clearly demonstrate the medical necessity.

The surgeon is responsible for all aspects of the procedure, including pre-operative assessment, surgical technique, and post-operative care.

IMPORTANT:For AV fistula repair, see codes 35180-35190.Code 35266 should be used for upper extremity blood vessel repair with a graft other than a vein.Code +35572 is used for harvesting a femoropopliteal vein segment.

In simple words: The doctor repairs a damaged blood vessel in your arm or hand using a piece of vein taken from another part of your body. They make a cut to reach the damaged vessel, carefully repair it with the vein graft, and make sure blood flows properly afterward.They then close the incision.

This CPT code, 35236, represents the surgical repair of a damaged or abnormal blood vessel located in an upper extremity.The repair utilizes a vein graft harvested from another site in the body (often the saphenous vein). The procedure involves accessing the damaged vessel via incision, dissecting surrounding tissue, controlling bleeding, preparing and suturing the vein graft into place, and verifying successful blood flow restoration using methods like Doppler ultrasound. Incision closure completes the procedure.

Example 1: A patient presents with a traumatic injury to the brachial artery resulting in significant blood loss and compromised circulation to the hand.Repair with a saphenous vein graft is performed using code 35236., A patient with peripheral artery disease (PAD) experiences critical limb ischemia due to stenosis of the radial artery. Surgical repair with a vein graft is performed utilizing code 35236., A patient presents with an arteriovenous fistula that requires surgical repair. Due to the nature of the fistula repair, code 35236 would not be appropriate; codes 35180-35190 should be used instead.

* Pre-operative assessment including history and physical examination, relevant imaging studies (angiograms, ultrasound), and patient consent.* Intraoperative findings documenting the location, extent, and nature of the vascular injury.* Detailed operative report including the type and source of the vein graft, description of surgical techniques used, and amount of blood loss.* Post-operative assessment and follow-up including wound healing, assessment of perfusion, and complication documentation.

** Accurate documentation of the type of graft used (e.g., autologous saphenous vein) is critical for correct coding.The extent of the repair (length of vessel repaired) might influence the level of complexity, but this is not explicitly reflected in the code itself.

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