© Copyright 2025 American Medical Association. All rights reserved.
A congenital arteriovenous fistula is a vascular anomaly characterized by an abnormal connection between an artery and a vein that is present from birth. This condition can manifest anywhere within the vascular system and can vary significantly in terms of size and length. The presence of this abnormal communication allows blood to flow under high pressure from the artery directly into the vein. Since the walls of veins are not designed to withstand the high-pressure flow typical of arterial blood, they can become stretched and enlarged over time. This enlargement can lead to an increased volume of blood flowing into the venous structure, which may result in various cardiovascular complications. Repairing congenital arteriovenous fistulas can be particularly challenging due to their potential extension into surrounding anatomical structures. To facilitate the repair process, a separate angiography may be performed to clearly outline the path of the fistula. The surgical procedure involves exposing the fistula, carefully dissecting it from adjacent tissues, and placing clamps on both the artery and vein to isolate the fistula. The abnormal connection is then severed, and the artery and vein are repaired, either with sutures or by using a synthetic patch or vein graft. After ensuring hemostasis, the overlying tissues are closed in layers. This procedure is specifically coded as CPT® 35182 when performed in the thorax and abdomen, distinguishing it from similar procedures in other anatomical locations.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure is indicated for the repair of congenital arteriovenous fistulas located in the thorax and abdomen. These fistulas may lead to complications due to the abnormal high-pressure blood flow from arteries into veins, which can cause venous enlargement and other cardiovascular issues. Surgical intervention is necessary to correct the abnormal communication and restore normal blood flow dynamics.
The procedure for repairing a congenital arteriovenous fistula in the thorax and abdomen involves several critical steps. First, a separate angiography is performed to delineate the course of the arteriovenous fistula, providing the surgeon with a clear understanding of its anatomy and relationship to surrounding structures. Following this, the surgeon makes an incision to expose the fistula and carefully dissects it free from the surrounding tissues to ensure that the area is adequately prepared for repair.
Post-procedure care involves monitoring the patient for any signs of complications, such as bleeding or infection at the surgical site. Patients may require follow-up imaging studies to ensure that the repair is successful and that normal blood flow has been restored. Recovery time can vary based on the individual patient's health and the complexity of the repair, but careful observation and management are essential to ensure optimal outcomes.
| Short Descr | RPR CGEN AV FISTULA THRX&ABD | Medium Descr | REPAIR CONGENITAL AV FISTULA THORAX & ABDOMEN | Long Descr | Repair, congenital arteriovenous fistula; thorax and abdomen | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 2 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |