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The CPT® Code 35682 refers to a surgical procedure known as an autogenous composite bypass graft, which involves the use of two segments of veins harvested from two different locations. This procedure is typically performed when a patient does not have sufficient vein material available in the limb that requires the bypass. In such cases, the physician will harvest segments of vein from a different limb, ensuring that the graft can be constructed effectively. The veins that may be utilized for this procedure include the contralateral greater saphenous vein, lesser saphenous vein, superficial femoral vein, or veins from the arm such as the cephalic or basilic veins. The harvested vein segments are then carefully anastomosed, or surgically connected, to create a conduit that is of the necessary length to facilitate the bypass. This technique is crucial for patients who require bypass surgery but lack adequate vein supply in the affected limb, thereby allowing for successful revascularization and improved blood flow to the targeted area.
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The procedure associated with CPT® Code 35682 is indicated for patients who require a bypass graft but do not have an adequate segment of vein available in the limb undergoing the procedure. The following conditions may warrant the use of this surgical intervention:
The procedure for CPT® Code 35682 involves several critical steps to ensure the successful construction of an autogenous composite bypass graft. The following outlines the procedural steps:
Following the completion of the bypass graft procedure, patients are typically monitored in a recovery area for any signs of complications, such as bleeding or infection. Post-procedure care may include pain management, monitoring of vital signs, and assessment of the graft's functionality. Patients are often advised on activity restrictions and follow-up appointments to ensure proper healing and to evaluate the success of the graft. Rehabilitation may also be recommended to aid in recovery and improve overall vascular health.
| Short Descr | COMPOSITE BYP GRFT 2 VEINS | Medium Descr | BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS | Long Descr | Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 0 - Payment restriction for assistants at surgery applies 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 35556 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; femoral-popliteal | 35566 | MPFS Status: Active Code APC C CPT Assistant Article Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels | 35570 | MPFS Status: Active Code APC C Illustration for Code Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial | 35571 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels | 35583 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-popliteal | 35585 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery | 35587 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; popliteal-tibial, peroneal |
| 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Guideline information changed. |
| 2010-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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