2025 CPT code 35695
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Transposition and/or reimplantation of carotid to subclavian artery.
Modifiers may apply, for example for bilateral procedures (50), or increased procedural services (22).
Medical necessity must be established by demonstrating significant carotid artery disease or damage that compromises cerebral blood flow, and for which transposition is a clinically appropriate solution. Documentation should support the diagnosis, severity of the condition, and the rationale for choosing transposition over other treatment options.
The surgeon is responsible for the entire procedure including prepping the patient, making the incisions, exposing and dividing the artery, performing the anastomosis, checking graft patency, closing incisions, and post operative care.
In simple words: This surgery reroutes blood flow to the brain by connecting the carotid artery to the subclavian artery in the neck, bypassing a blockage in the carotid artery.This improves blood supply to the brain.
This procedure involves exposing the carotid artery, dividing it, and then anastomosing it to the subclavian artery to bypass a blockage and improve blood flow to the brain.The surgeon makes an incision above the clavicle, exposes the carotid and subclavian arteries, divides the carotid above the stenosis, and then connects the healthy portion of the carotid to the subclavian artery. The patency of the graft may be checked via arteriography or ultrasound.
Example 1: A patient with severe stenosis of the left carotid artery undergoes a carotid to subclavian artery transposition to restore blood flow to the brain., A patient with a carotid artery aneurysm has a transposition of the carotid to the subclavian artery to bypass the aneurysm., Following trauma to the neck, a patient's carotid artery is damaged, necessitating a transposition to the subclavian artery to maintain cerebral blood flow.
Documentation should include operative report detailing the procedure, including the location and severity of stenosis or other pathology, the method of transposition, confirmation of graft patency, and any complications encountered. Pre-operative imaging and post-operative care notes should also be documented.
** Prior authorization might be required by some payers.
- Payment Status: Inpatient Only (as of 2017)
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital