Summary & Overview
CPT 35697: Arterial Transposition and Reimplantation Procedures
CPT code 35697 designates an arterial transposition and/or reimplantation procedure that connects two arteries to improve arterial blood flow. These complex vascular reconstructions are performed to restore or reconfigure arterial circulation and are typically done in hospital operating rooms or specialized surgical centers. Nationally, such procedures have implications for surgical resource use, perioperative risk management, and payer coverage determinations.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, common service settings, and the national relevance of coding accuracy for claims processing. The publication outlines expected benchmarks related to utilization and billing classification where available, summarizes relevant policy considerations that affect coverage and documentation, and highlights areas where clinical detail in operative reports is important for correct CPT code selection.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related procedure codes, and detailed payer-specific rules is noted where applicable. The focus is on presenting the code definition, clinical and service context, and the types of information stakeholders should expect to review when assessing claims that use CPT code 35697.
Billing Code Overview
CPT code 35697 describes arterial transposition and/or reimplantation procedures in which two arteries are connected to improve arterial blood flow. Codes in the series 35691–35697 specify procedures that connect two arteries to each other during reconstruction of arterial circulation.
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Service type: Surgical arterial reconstruction involving transposition or reimplantation of arteries
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Typical site of service: Hospital operating room or specialized surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with symptomatic peripheral arterial disease or a congenital/iatrogenic arterial anomaly causing limb ischemia or compromised blood flow to an end-organ territory. The patient has progressive claudication, rest pain, non-healing ischemic ulceration, or acute limb ischemia despite conservative management. Diagnostic workup includes arterial duplex ultrasound, CT angiography or MR angiography confirming a lesion or malpositioned arterial origin amenable to arterial transposition or reimplantation. Preoperative evaluation entails vascular surgery consultation, cardiopulmonary risk assessment, optimization of anticoagulation/antiplatelet therapy, and informed consent explaining risks of bleeding, graft failure, infection, and limb loss.
The clinical workflow: the patient is admitted for an elective or urgent vascular operation. In the operating room or hybrid suite, under general or regional anesthesia, the vascular surgeon exposes the involved arteries, mobilizes the donor and recipient arteries, performs arterial transposition and/or reimplantation with end-to-end or end-to-side anastomosis, and confirms flow with intraoperative duplex or angiography. Postoperative care includes monitoring in PACU or ICU as indicated, vascular assessments of distal pulses, anticoagulation management, wound care, and scheduled imaging follow-up to assess patency. Typical documentation includes preoperative diagnosis, indication for revascularization, detailed operative note describing arteries connected, method of anastomosis, graft or patch use if any, intraoperative findings, and postoperative plan.
Coding Specifications
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