© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 35256 involves the surgical repair of a blood vessel in the lower extremity using a vein graft. This procedure is typically indicated when there is an injury to a blood vessel in the leg that requires reconstruction to restore proper blood flow. 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 crucial as it helps to control any bleeding that may occur during the procedure. In some cases, to maintain blood flow to the area 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 surgical team checks for hemostasis along the suture line to ensure that there is no further bleeding. Finally, the overlying tissues are sutured back together in layers to complete the procedure, ensuring that the surgical site is properly closed and that healing can begin.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 35256 is indicated for the repair of a blood vessel in the lower extremity that has been compromised due to injury. The specific indications for performing this procedure include:
The procedure for repairing a blood vessel with a vein graft in the lower extremity involves several critical steps, which are outlined as follows:
After the completion of the vein graft repair, post-procedure care is essential for ensuring optimal recovery. Patients are typically monitored for any signs of complications, such as bleeding or infection at the surgical site. Pain management strategies may be implemented to address discomfort following the surgery. Additionally, the patient may be advised on activity restrictions to promote healing and prevent strain on the repaired blood vessel. Follow-up appointments are crucial for assessing the success of the graft and ensuring that blood flow is adequately restored to the lower extremity.
| Short Descr | REPAIR BLVSL VN GRF LXTR | Medium Descr | REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY | Long Descr | Repair blood vessel with vein graft; lower extremity | 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 | 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. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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) | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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. |