2025 CPT code 35188
Effective Date: N/A Surgery - Cardiovascular System Feed
Repair of acquired or traumatic arteriovenous fistula in the head and neck.
Modifiers may be applicable, such as 22 (Increased Procedural Services), 59 (Distinct Procedural Service) or others as appropriate.
Medical necessity for 35188 is established by documenting the presence of an acquired or traumatic arteriovenous fistula in the head and neck causing significant symptoms or complications such as pain, swelling, skin changes, reduced blood flow to surrounding tissues, or high-output cardiac failure.
The physician is responsible for the entire surgical procedure, from prepping and anesthetizing the patient to repairing the fistula and ensuring proper blood flow is restored.
In simple words: This procedure fixes an abnormal connection between an artery and a vein in your head or neck that happened because of an injury or other event. The surgeon makes a cut to find the connection, closes it off, and then fixes the blood vessels. They might use stitches or a patch to repair the vessels. They also check that the blood is flowing properly again.
Surgical repair of an arteriovenous fistula in the head and neck region that was acquired after birth due to trauma or other causes. This includes exposing the fistula, clamping the involved vessels, interrupting the abnormal connection, and reconstructing the artery and vein using sutures or a graft. Doppler ultrasound may be used to confirm blood flow restoration. The incision is then closed in layers.
Example 1: A patient presents with a pulsating mass in the neck following a penetrating injury. Imaging reveals a traumatic arteriovenous fistula. The patient undergoes surgical repair using 35188., A patient with a history of neck surgery develops swelling, warmth, and a noticeable murmur in the neck. An arteriovenous fistula is diagnosed. The fistula is repaired using 35188., An arteriovenous fistula forms in a patient's head following radiation therapy. The patient experiences symptoms of arterial insufficiency and venous hypertension. Surgical intervention is performed using 35188 to correct the fistula.
Documentation should include details about the fistula's etiology (traumatic, acquired), location, size, associated symptoms, operative findings, method of repair (suture, graft), and confirmation of blood flow restoration. Pre- and postoperative imaging reports should also be included.
- Revenue Code: P2F
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center