© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 35246 involves the surgical repair of an intrathoracic blood vessel using a vein graft. This procedure is typically indicated when there is an injury to a blood vessel located within the chest cavity. The term "intrathoracic" refers to the area within the thorax, which houses vital structures such as the heart and lungs. The surgical approach often involves a median sternotomy, which is a common technique where the chest is opened along the sternum to provide access to the heart and surrounding vessels. In some cases, depending on the severity and nature of the injury to the blood vessel, cardiopulmonary bypass may be initiated to maintain blood circulation and oxygenation during the repair process. During the procedure, the injured blood vessel is carefully exposed, and clamps are applied both proximal and distal to the injury site to control any bleeding. The surgeon evaluates the extent of the damage to the blood vessel to determine the appropriate course of action. A vein, often harvested from the saphenous vein in the lower leg, is prepared to serve as a graft. The edges of the damaged blood vessel are debrided to ensure a clean surface for the graft. The prepared vein graft is then meticulously sewn to the ends of the injured blood vessel, allowing for restoration of blood flow. After the clamps are released, the surgical team checks for hemostasis along the suture line to ensure there is no further bleeding. If cardiopulmonary bypass was utilized, the patient is carefully taken off bypass before the overlying tissues are sutured back together in layers. This procedure is specifically coded as CPT® 35246 when performed without the use of cardiopulmonary bypass, distinguishing it from similar procedures that may require this additional support.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 35246 is indicated for the repair of an intrathoracic blood vessel that has sustained injury. This may occur due to various conditions, including trauma, surgical complications, or vascular diseases that compromise the integrity of the blood vessel. The primary goal of the procedure is to restore normal blood flow and prevent complications such as hemorrhage or ischemia. The specific indications for performing this procedure include:
The procedure for CPT® Code 35246 involves several critical steps to ensure the successful repair of the injured intrathoracic blood vessel. The steps are as follows:
After the completion of the procedure coded as CPT® 35246, the patient is monitored closely in a recovery area. Post-procedure care includes assessing vital signs, managing pain, and monitoring for any signs of complications such as bleeding or infection at the surgical site. The patient may require additional imaging studies to evaluate the success of the graft and ensure proper blood flow through the repaired vessel. Recovery time can vary based on the individual patient's condition and the extent of the surgery, but patients are typically advised on activity restrictions and follow-up appointments to ensure optimal healing and recovery.
| Short Descr | RPR BLVSL VN GRF NTRTHRC W/O | Medium Descr | RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP | Long Descr | Repair blood vessel with vein graft; intrathoracic, without bypass | 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 | 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 |
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). | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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) |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |