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Official Description

Repair blood vessel with vein graft; intra-abdominal

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35251 involves the surgical repair of an intra-abdominal blood vessel using a vein graft. This procedure is typically indicated when there is an injury to a blood vessel within the abdominal cavity, 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 surgeon exposes the injured blood vessel and applies clamps both proximal and distal to the site of injury. This clamping is crucial as it helps to control any bleeding that may occur during the procedure. Once the area is adequately prepared, the extent of the injury is carefully assessed to determine the appropriate course of action. To facilitate the repair, a segment of vein is harvested, most commonly from the saphenous vein located in the lower leg. This harvested vein is then meticulously prepared for grafting. The next step involves debriding the edges of the damaged blood vessel to ensure a clean surface for the graft. The prepared vein graft is then sutured to both the proximal and distal ends of the injured vessel, effectively creating a new pathway for blood flow. After the graft is in place, the clamps are released, and 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 abdominal blood vessel.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35251 is indicated for the repair of an intra-abdominal blood vessel that has been compromised due to various conditions. The following are specific indications for performing this procedure:

  • Trauma: Injury to the abdominal blood vessels resulting from accidents or penetrating injuries.
  • Vascular Disease: Conditions such as aneurysms or occlusions that necessitate surgical intervention to restore blood flow.
  • Congenital Anomalies: Structural abnormalities in blood vessels that may require surgical correction.

2. Procedure

The procedure for repairing an intra-abdominal blood vessel with a vein graft involves several critical steps, each essential for successful outcomes.

  • Step 1: Exposure of the Injured Vessel The surgeon begins by making an incision to access the abdominal cavity and expose the injured blood vessel. This step is crucial as it allows for direct visualization and manipulation of the affected area.
  • Step 2: Clamping the Vessel Once the vessel is exposed, clamps are applied both proximal and distal to the injury site. This clamping is necessary to control bleeding and create a bloodless field for the repair.
  • Step 3: Evaluation of the Injury The extent of the injury is then assessed. This evaluation helps the surgeon determine the appropriate length and type of graft needed for the repair.
  • Step 4: Harvesting the Vein A segment of vein, typically the saphenous vein from the lower leg, is harvested. This vein is chosen for its suitability as a graft due to its size and structure.
  • Step 5: Preparing the Graft The harvested vein is prepared for grafting. This preparation may involve cleaning and sizing the vein to ensure it fits properly with the injured vessel.
  • Step 6: Debriding the Vessel Edges The edges of the injured blood vessel are debrided to remove any damaged tissue. This step is vital for ensuring a clean surface for the graft to adhere to.
  • Step 7: Suturing the Graft The prepared vein graft is then sutured to the proximal and distal ends of the injured blood vessel. This connection restores continuity and allows for normal blood flow through the graft.
  • Step 8: Releasing the Clamps After the graft is securely in place, the clamps are released. The surgeon checks for hemostasis, ensuring that there is no bleeding along the suture line.
  • Step 9: Repairing Overlying Tissues Finally, the overlying tissues are repaired in layers using sutures. This step is important for restoring the integrity of the abdominal wall and promoting proper healing.

3. Post-Procedure

Post-procedure care following the repair of an intra-abdominal blood vessel with a vein graft involves monitoring for complications and ensuring proper recovery. Patients are typically observed for signs of bleeding, infection, or graft failure. Pain management is also an important aspect of post-operative care. The surgical site may require dressing changes, and patients are advised on activity restrictions to promote healing. Follow-up appointments are essential to assess the success of the graft and the overall recovery process. Additionally, any specific instructions regarding diet, wound care, and medication adherence should be provided to the patient to facilitate optimal recovery.

Short Descr RPR BLVSL VN GRF INTRA-ABDL
Medium Descr REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL
Long Descr Repair blood vessel with vein graft; intra-abdominal
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).
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).
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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