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2025 CPT code 35881

Revision of a lower extremity arterial bypass graft using a segmental vein interposition without thrombectomy, performed open.

Follow CPT guidelines for vascular surgery procedures.Code selection should accurately reflect the procedure performed and the extent of services rendered.The use of appropriate modifiers is crucial to ensure accurate billing.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, 22 for increased procedural services).

Medical necessity is established by evidence of inadequate blood flow in the lower extremity, which is documented through clinical symptoms, physical examination findings (e.g., diminished pulses, cool extremities), and imaging studies. The revision of the bypass graft with segmental vein interposition is deemed medically necessary to restore adequate perfusion and alleviate symptoms.

The surgeon is responsible for all aspects of the procedure, including patient preparation, incision, dissection, harvesting of the vein graft, anastomosis (surgical connection of vessels), and closure of the incision.Preoperative and postoperative care may be coded separately.

IMPORTANT:For revision of femoral anastomosis of synthetic arterial bypass graft, see 35883, 35884. For excision of infected graft, see 35901-35907 and appropriate revascularization code. For a similar service using patch graft instead of segmental vein interposition, see 35879.

In simple words: The surgeon fixes a narrowed area in a leg artery bypass graft by replacing the narrowed part with a segment of vein taken from elsewhere in the body.No blood clots are removed during this procedure.

This CPT code encompasses the open surgical revision of a lower extremity arterial bypass graft.The procedure involves the replacement of a narrowed area within the existing graft using a segmental vein interposition graft harvested from another location. Thrombectomy is not included. The procedure includes all necessary steps, such as incision, dissection, graft harvesting, anastomosis, and closure.

Example 1: A patient presents with a narrowed area in a previously placed lower extremity arterial bypass graft, causing decreased blood flow.The surgeon performs an open revision of the graft using a segmental vein interposition graft to restore blood flow., A patient has a lower extremity arterial bypass graft that has developed a stenosis (narrowing) distal to a previous anastomosis. The surgeon performs an open revision using a harvested segment of vein to bypass the stenosis., A patient experiences recurrent symptoms of peripheral artery disease despite having undergone a lower extremity arterial bypass.A revision of the bypass graft with a vein interposition is performed to improve blood flow.

Preoperative assessment including patient history, physical examination, and relevant imaging studies (e.g., angiography, Doppler ultrasound). Intraoperative documentation including details of the procedure (incisions, dissection, graft harvesting, anastomosis technique, and hemostasis). Postoperative care and any complications.

** This code does not include thrombectomy.Separate codes should be used for any additional procedures performed during the same surgical session.Accurate documentation is essential for proper coding and reimbursement.

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