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Official Description

Excision of infected graft; neck

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35901 involves the excision of an infected vascular graft located in the neck region. This surgical intervention is necessary when a vascular graft, which is a synthetic or biological conduit used to restore blood flow, becomes infected. Infections in grafts can lead to serious complications, including the risk of systemic infection and compromised blood flow to the affected area. The excision process typically requires a prior re-vascularization procedure, which involves the placement of a new graft to ensure that the organ or limb continues to receive adequate blood supply during the excision of the infected graft. The surgical team carefully exposes the infected graft and dissects it free from surrounding tissues to minimize damage to adjacent structures. The inflow and outflow arteries, which supply blood to and from the graft, are clamped to control blood flow during the procedure. The excision is performed with precision, followed by debridement of the arterial walls at the anastomosis sites to remove any inflamed tissue. Finally, the arterial defect is repaired with sutures to restore the integrity of the blood vessels. This procedure is critical for managing infections in vascular grafts and preventing further complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The excision of an infected vascular graft in the neck, as described by CPT® Code 35901, is indicated in the following scenarios:

  • Infected Vascular Graft: The primary indication for this procedure is the presence of an infection in a vascular graft located in the neck, which may lead to complications if not addressed.
  • Compromised Blood Flow: Situations where the infected graft is causing inadequate perfusion to the affected organ or limb necessitate intervention to restore proper blood flow.
  • Surrounding Tissue Inflammation: The presence of inflamed tissue around the graft site that poses a risk of further complications or systemic infection may also warrant excision.

2. Procedure

The procedure for excising an infected vascular graft in the neck involves several critical steps:

  • Step 1: Re-vascularization Procedure: Before the excision of the infected graft, a separately reportable re-vascularization procedure is typically performed. This step is essential to place a new graft, ensuring that the affected organ or limb receives adequate blood supply during the excision process.
  • Step 2: Exposure of the Infected Graft: The surgical team carefully exposes the infected graft by dissecting it free from the surrounding tissues. This step is crucial to access the graft without causing damage to adjacent structures.
  • Step 3: Clamping of Arteries: The inflow and outflow arteries are clamped above and below the graft. This clamping is necessary to control blood flow and minimize bleeding during the excision.
  • Step 4: Excision of the Graft: The infected graft is excised from the neck. This step involves careful removal to ensure that all infected tissue is eliminated.
  • Step 5: Debridement of Arterial Walls: The inflow and outflow arterial walls at the proximal and distal anastomosis sites are debrided until normal, non-inflamed artery tissue is encountered. This debridement is essential to remove any infected or inflamed tissue that could compromise healing.
  • Step 6: Debridement of Surrounding Tissue: Any inflamed tissue surrounding the graft site is also debrided to promote healing and reduce the risk of further infection.
  • Step 7: Repair of Arterial Defect: Finally, the arterial defect created by the excision is repaired with sutures, restoring the integrity of the blood vessels and ensuring proper blood flow.

3. Post-Procedure

Post-procedure care following the excision of an infected vascular graft in the neck includes monitoring for signs of infection, ensuring proper healing of the surgical site, and assessing the functionality of the newly placed graft. Patients may require follow-up imaging studies to evaluate blood flow and graft patency. Additionally, pain management and wound care instructions are provided to facilitate recovery. It is essential to monitor the patient for any complications, such as bleeding or further infection, and to ensure that the arterial repair is healing appropriately.

Short Descr EXCISION GRAFT NECK
Medium Descr EXCISION INFECTED NECK GRAFT
Long Descr Excision of infected graft; neck
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) 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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 51 - Endarterectomy, vessel of 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).
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).
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
2011-01-01 Changed Short description changed.
1994-01-01 Added First appearance in code book in 1994.
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