2025 CPT code 35879
Effective Date: N/A Surgery - Cardiovascular System Feed
Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty.
Modifiers may apply based on specific circumstances. Examples include modifier 22 (Increased Procedural Services) if the procedure was significantly more complex than usual, or modifier 50 (Bilateral Procedure) if performed on both legs.
Medical necessity for this procedure must be established by documenting the patient's symptoms (e.g., claudication, rest pain, tissue loss) and objective evidence of the stenosis impacting blood flow to the lower extremity. The documentation should clearly demonstrate that the procedure is necessary for the patient's health and well-being.
The surgeon is responsible for the entire procedure, including prepping and anesthetizing the patient, making the incisions, dissecting tissue, harvesting the vein graft, applying the patch, checking blood flow, and closing the incisions.
In simple words: The surgeon repairs a narrowed section of a bypass graft in the leg by opening the graft and sewing in a patch made from a vein. This widens the narrowed part of the graft and improves blood flow to the leg.
This code describes a procedure where the surgeon revises a lower extremity arterial bypass graft that has a stenosis (narrowing) by opening the graft and applying a vein patch to widen the narrowed area. This procedure does not include removing a blood clot (thrombectomy). The vein patch is typically taken from another area of the patient's body.The surgeon makes an incision over the existing bypass graft, dissects the tissue to expose the graft, and confirms the location of the stenosis. A vein is harvested from a donor site, prepared, and then sutured onto the opened bypass graft as a patch to widen the narrowed area. Blood flow is checked after the patch is in place, and the incisions are closed.
Example 1: A patient with a previous lower extremity bypass graft develops a stenosis causing decreased blood flow to the leg. The surgeon performs a revision of the bypass graft using a vein patch angioplasty to widen the narrowed area and restore blood flow. No thrombectomy is necessary, A patient presents with claudication (leg pain with exertion) due to a stenosis in their femoral-popliteal bypass graft. The surgeon performs a revision of the bypass graft with vein patch angioplasty to address the stenosis and relieve the patient's symptoms. No thrombus is present., A patient with a history of peripheral artery disease and a previous lower extremity bypass graft experiences rest pain in the affected leg. Angiography reveals a significant stenosis in the bypass graft. The surgeon performs a revision of the graft with vein patch angioplasty to widen the narrowed area and alleviate the rest pain.
Documentation should include details of the original bypass graft surgery, the presence and location of the stenosis (e.g., imaging studies), the source of the vein patch, the method of angioplasty, intraoperative findings, and confirmation of restored blood flow.
- Revenue Code: P2F - Major Procedure, Cardiovascular - Other
- Specialties:Vascular Surgery, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center