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Official Description

Repair blood vessel with vein graft; neck

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35231 involves the surgical repair of a blood vessel located in the neck using a vein graft. This procedure is typically indicated when there is an injury to a blood vessel in the neck, which may result from trauma, disease, or other medical conditions. The approach taken during the surgery is contingent upon the specific blood vessel that has sustained damage. Initially, the injured blood vessel is accessed surgically, and clamps are applied both proximal and distal to the site of injury. This clamping is essential to control any bleeding that may occur during the procedure. In some cases, to maintain blood flow while the repair is being performed, a temporary shunt may be placed. Once the area is adequately prepared, the extent of the injury is carefully assessed. A segment of vein, often harvested from the saphenous vein located in the lower leg, is then prepared for use as a graft. The edges of the damaged blood vessel are debrided to ensure a clean surface for the grafting process. The prepared vein graft is meticulously sewn to both the proximal and distal ends of the injured blood vessel, effectively bridging the gap created by the injury. After the graft is secured, the temporary shunt is removed, and the clamps are released. At this stage, the surgeon checks for hemostasis, ensuring that there is no bleeding along the suture line. Finally, the overlying tissues are repaired in layers with sutures, completing the procedure and restoring the integrity of the blood vessel in the neck.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35231 is indicated for the repair of a blood vessel in the neck that has been compromised due to various conditions. The following are specific indications for performing this procedure:

  • Trauma: Injuries to the neck that result in damage to blood vessels, often due to accidents or penetrating injuries.
  • Vascular Disease: Conditions such as atherosclerosis or aneurysms that may lead to the weakening or rupture of blood vessels in the neck.
  • Congenital Anomalies: Structural abnormalities present at birth that affect the integrity of neck blood vessels.

2. Procedure

The procedure for repairing a blood vessel with a vein graft in the neck involves several critical steps, each designed to ensure a successful outcome. The following outlines the procedural steps:

  • Step 1: The surgical team begins by accessing the injured blood vessel in the neck. This involves making an incision in the skin to expose the underlying structures.
  • Step 2: Once the blood vessel is located, clamps are applied both proximal and distal to the injury site. This clamping is crucial for controlling bleeding during the repair process.
  • Step 3: If necessary, a temporary shunt is placed to maintain blood flow while the repair is being performed. This step is particularly important in cases where blood flow must be preserved to prevent ischemia.
  • Step 4: The extent of the injury to the blood vessel is carefully evaluated. This assessment helps determine the appropriate length and type of graft needed for the repair.
  • Step 5: A segment of vein, typically harvested from the saphenous vein in the lower leg, is prepared for grafting. This involves careful dissection and preparation of the vein to ensure it is suitable for use.
  • Step 6: The edges of the injured blood vessel are debrided to remove any damaged tissue, creating a clean surface for the graft to adhere to.
  • Step 7: The prepared vein graft is then sewn to the proximal and distal ends of the injured blood vessel. This step is critical for re-establishing continuity and restoring blood flow.
  • Step 8: After the graft is secured, the temporary shunt is removed, and the clamps are released. The surgical team checks for hemostasis along the suture line to ensure there is no active bleeding.
  • Step 9: Finally, the overlying tissues are repaired in layers using sutures, completing the procedure and ensuring proper closure of the incision site.

3. Post-Procedure

After the completion of the procedure, patients typically require monitoring for any signs of complications, such as bleeding or infection. The recovery process may involve pain management and follow-up appointments to assess the healing of the graft and the integrity of the blood vessel repair. Patients may also be advised on activity restrictions to promote optimal healing and prevent strain on the surgical site. It is essential for healthcare providers to provide clear post-operative care instructions to ensure a successful recovery.

Short Descr REPAIR BLVSL VN GRF NECK
Medium Descr REPAIR BLOOD VESSEL W/VEIN GRAFT NECK
Long Descr Repair blood vessel with vein graft; neck
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) 1 - 150% payment adjustment for bilateral procedures applies.
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 Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 2
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck

This is a primary code that can be used with these additional add-on codes.

35572 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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