© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 35685 refers to the procedure involving the placement of a vein patch or cuff at the distal anastomosis of a bypass graft that utilizes a synthetic conduit. This procedure is performed during a separately reportable arterial bypass operation and is intended to enhance the patency, or openness, of the synthetic bypass graft. The vein patch or cuff serves as an additional support structure at the connection point where the synthetic graft meets the artery, thereby potentially improving blood flow and reducing the risk of complications associated with graft failure. Two primary techniques are utilized for this procedure: the Taylor patch technique and the Miller cuff technique. In the Taylor patch technique, a small segment of the patient's own vein is harvested and then sutured to the artery at the distal anastomosis site, followed by the attachment of the synthetic graft to this vein patch. Conversely, the Miller cuff technique involves creating a short cuff from the harvested vein that is directly sutured to the artery, with the synthetic graft then attached to this cuff. Both techniques aim to optimize the surgical outcome by ensuring a secure and effective connection between the synthetic graft and the arterial system.
© Copyright 2025 Coding Ahead. All rights reserved.
The placement of a vein patch or cuff at the distal anastomosis of a bypass graft is indicated in the following scenarios:
The procedure for the placement of a vein patch or cuff at the distal anastomosis involves several key steps, which are detailed below:
After the placement of the vein patch or cuff, the patient will typically undergo monitoring to assess the success of the procedure and the patency of the graft. Post-procedure care may include managing any surgical wounds, monitoring for signs of infection, and ensuring proper blood flow through the graft. The recovery process will vary depending on the individual patient's condition and the extent of the surgical procedure performed. Follow-up appointments will be necessary to evaluate the effectiveness of the graft and the need for any further interventions.
| Short Descr | BYPASS GRAFT PATENCY/PATCH | Medium Descr | PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT | Long Descr | Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (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) | 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 2 | CCS Clinical Classification | 55 - Peripheral vascular bypass |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 35656 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Bypass graft, with other than vein; femoral-popliteal | 35666 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery | 35671 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Bypass graft, with other than vein; popliteal-tibial or -peroneal artery |
| 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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 | 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) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2002-01-01 | Added | First appearance in code book in 2002. |
Get instant expert-level medical coding assistance.