2025 CPT code 35681
Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Creation of a composite graft using vein and synthetic material for bypass.
Modifiers may be applicable to further specify the circumstances of the procedure. Refer to current CPT coding guidelines for appropriate modifier usage.
Medical necessity for this code is established when a composite graft is required due to the unsuitability or inadequacy of autogenous vein for bypass grafting. Documentation should clearly support the reasons for using a composite graft, such as previous procedures, inadequate vein length or quality, or anatomical constraints.
The physician performs this add-on procedure when a suitable autogenous vein is unavailable for bypass grafting.This could be due to previous surgeries, inadequate vein length, anatomical issues, or vein conditions like sclerosis.The physician harvests the vein, constructs the composite graft by meticulously suturing the vein and synthetic material, and tests the graft for patency.
In simple words: This additional procedure involves creating a combined graft using the patient's vein and a synthetic material. This is used when the patient's vein is not long enough or suitable for a bypass. The combined graft is then used in a separate procedure to bypass a blocked blood vessel.
This add-on procedure involves creating a composite graft, or conduit, from vein and synthetic materials for use in bypass grafting. It's used when an adequate length of autogenous vein isn't available, due to prior procedures or anatomical reasons. The surgeon constructs the graft by attaching the vein and synthetic material with sutures, ensuring patency. This code is reported in addition to the primary code for graft placement.
Example 1: A patient with prior lower extremity bypass surgery requires a new bypass, but the remaining saphenous vein is too short. The surgeon creates a composite graft using a section of the saphenous vein and a piece of ePTFE to achieve the necessary length., A patient with severe atherosclerosis in the femoral artery requires a bypass to the anterior tibial artery.Due to the patient's medical history, the available autologous vein is of poor quality. The surgeon constructs a composite graft using a portion of suitable vein and synthetic material to ensure graft integrity., A patient needs a distal arterial bypass. However, the greater saphenous vein has multiple branches, making it unsuitable for a full-length graft.A composite graft is created using a segment of the saphenous vein and a synthetic graft material to create a functional bypass conduit.
Documentation should include the reason for using a composite graft (e.g., inadequate autogenous vein, prior procedures), the type of synthetic material used, the source of the vein segment, the location of the bypass, and confirmation of graft patency.
- Revenue Code: P2F
- Specialties:Cardiovascular Surgery, Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center