2025 CPT code 35518
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Axillary-axillary bypass graft using a vein.
Modifiers may apply depending on the specific circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services, 78 for unplanned return to the OR). Consult the current CPT coding guidelines for proper modifier usage.
Medical necessity is established by documentation showing significant stenosis or occlusion of the axillary arteries causing ischemia or symptoms requiring revascularization.Preoperative imaging studies must clearly demonstrate the need for the procedure. Postoperative monitoring should also be appropriately documented.
The surgeon is responsible for all aspects of the procedure, including patient preparation, incision, harvesting of the vein graft (if necessary), artery access, graft placement and anastomosis, hemostasis, and wound closure.
In simple words: The doctor creates a detour around a blocked blood vessel in the armpit area by using a piece of vein as a bridge to reconnect the blood flow. This might involve taking the vein from another part of the body.
This CPT code 35518 represents the creation of an axillary-axillary bypass graft using a vein.The procedure involves bypassing a blocked blood vessel by inserting a graft that connects one axillary artery to the other axillary artery. This may involve harvesting a vein graft from another location in the body. The surgeon makes incisions near the collarbones, accesses the axillary arteries, applies clamps, creates openings in the arteries, attaches the graft ends, passes the graft through a tunnel, removes clamps to restore blood flow, and closes the incisions after ensuring hemostasis.
Example 1: A patient presents with significant stenosis of both axillary arteries, resulting in reduced blood flow to the arms and hands.An axillary-axillary bypass graft using a harvested great saphenous vein is performed to restore adequate blood flow., A patient with a traumatic injury to the axillary artery requires reconstruction.A vein graft is used to bypass the injured segment and restore blood flow. This procedure would be coded with 35518., A patient with a history of axillary artery thrombosis experiences recurrent ischemia in the upper extremity. A surgical bypass is performed to alleviate symptoms, utilizing a harvested cephalic vein as a graft. This is coded as 35518.
Preoperative assessment including medical history, physical examination findings, imaging studies (angiograms) demonstrating the need for the bypass, operative report detailing the procedure steps (incisions, graft harvest site and technique, anastomoses, hemostasis methods, drain placement if any), postoperative course, and any complications.
** Always refer to the most up-to-date CPT codebook and payer guidelines for accurate coding and reimbursement.The specific type of vein graft used should be documented.This information is crucial for appropriate coding and billing.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: This information is not available in the provided text.RVUs vary by location and payer.
- Global Days : This information is not provided in the source. Global period information would need to be obtained from payer-specific guidelines.
- Payment Status: Active
- Modifier TC rule: This information is not provided. Modifier -TC may or may not apply depending on the details of the procedure.Consult your payer guidelines.
- Fee Schedule : Fee schedule data is not provided.Historical fee information may be obtained from Medicare claims data or other payer fee schedules.
- Specialties:Vascular Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center