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The procedure described by CPT® Code 35884 involves the surgical revision of a femoral anastomosis that utilizes a synthetic arterial bypass graft. This operation is performed through an open approach, which means that the surgeon makes a direct incision in the groin area to access the previously placed arterial bypass graft. The primary purpose of this procedure is to address issues such as stenosis, which is a narrowing of the graft that can compromise its function and threaten the patency, or openness, of the graft. The bypass graft itself is a conduit that redirects blood flow from one artery to another, often used in cases where there are blockages or diseases affecting the blood vessels, such as those leading to the aorta, iliac, or popliteal arteries. During the revision, the surgeon carefully dissects the tissue to reach the anastomosis site, where the graft connects to the femoral artery. The integrity of this connection is assessed for any leaks or other complications. Once the problematic area is identified, clamps are applied to control blood flow, and the anastomosis site is incised to allow for further evaluation and repair. If a stenotic segment or other issues are found, this portion of the graft is excised. The repair is then performed using an autogenous vein patch graft, which is a section of vein harvested from the patient, ensuring that the graft is restored to a functional state. The new patch is meticulously sutured into place, and the anastomosis is reconnected to the femoral artery. After confirming the viability of the graft and ensuring that there are no leaks, the clamps are removed, and the surgical site is closed. This procedure is critical for maintaining adequate blood flow and preventing complications associated with graft failure.
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The procedure described by CPT® Code 35884 is indicated for patients who have undergone previous femoral anastomosis with a synthetic arterial bypass graft and are experiencing complications that necessitate surgical intervention. The specific indications for this procedure include:
The procedure for CPT® Code 35884 involves several critical steps to ensure the successful revision of the femoral anastomosis. These steps include:
Following the completion of the procedure, patients can expect a recovery period that may involve monitoring for any signs of complications, such as infection or graft failure. Post-operative care typically includes pain management, wound care, and follow-up appointments to assess the success of the revision. Patients may also be advised on activity restrictions to promote healing and ensure the integrity of the newly revised graft. Regular follow-up imaging may be necessary to monitor the patency of the graft and the overall success of the procedure.
| Short Descr | REVJ FEM ANAST AUTOG VN GRF | Medium Descr | REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF | Long Descr | Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft | 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 | 1 | 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. | 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). | 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) |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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