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2025 CPT code 35182

Repair of a congenital arteriovenous fistula located in the thorax or abdomen.

Follow CPT coding guidelines, including those related to surgical procedures and vascular surgery. Consult the official CPT manual for detailed guidelines.

Modifiers may be applicable depending on the circumstances of the procedure, such as location, multiple procedures, and assistant surgeons. Refer to the CPT manual for specific modifier guidelines.

Medical necessity for 35182 is established when the congenital arteriovenous fistula causes hemodynamic instability, significant tissue changes, symptoms (pain, swelling, high output cardiac failure), or the risk of rupture.

The surgeon is responsible for pre-operative preparation, incision, isolation and division of the AVF, repair of the vessels (using sutures or graft as needed), verification of normal blood flow, and closure of the incision.

IMPORTANT:35180 (head and neck), 35184 (extremities)

In simple words: This surgery fixes an abnormal connection between an artery and vein present since birth, located in the chest or abdomen. The surgeon makes a cut to reach the connection, seals it off, repairs the vessels, and checks blood flow. The cut is then stitched up.

This procedure involves surgical repair of a congenital arteriovenous fistula (AVF) situated in the thoracic or abdominal region.The surgeon makes an incision to access the AVF, applies clamps to isolate the abnormal connection between the artery and vein, and then severs the connection.Each vessel is then repaired using sutures or a graft material as needed.Post-repair, the surgeon verifies normal blood flow using methods such as Doppler ultrasound. The incision is closed in layers to minimize the risk of hematoma formation.

Example 1: A newborn infant is diagnosed with a congenital arteriovenous fistula in the abdomen causing significant hemodynamic compromise.Surgical repair using code 35182 is performed., A 10-year-old child presents with a large, symptomatic congenital arteriovenous fistula in the thorax. Surgical repair (35182) is required to address hemodynamic instability and the potential for complications such as rupture., An adult patient is diagnosed with a congenital arteriovenous fistula in the abdomen that has led to significant tissue expansion and pain. Surgical correction using 35182 is necessary to alleviate symptoms.

* Preoperative assessment including imaging (ultrasound, CT, MRI) to demonstrate the AVF.* Operative report detailing the surgical technique, size and location of the AVF, type of repair (sutures or graft), and assessment of post-operative blood flow.* Pathology report if any tissue is sent for analysis.* Postoperative imaging to confirm the successful repair.* Anesthesia record.* Progress notes reflecting the patient's postoperative course.

** Always refer to the most current CPT codebook for the most up-to-date information on coding, reimbursement, and guidelines.This information is current as of December 3, 2024.

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