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CPT 35870: Repair of Vascular Graft‑to‑Intestine Fistula
CPT code 35870 denotes surgical repair of an abnormal opening between a vascular graft and the intestines (graft-enteric fistula). This is a high-acuity vascular surgery addressing life-threatening risks including hemorrhage, sepsis, and graft failure. Nationally, accurate use of this CPT code supports appropriate surgical care documentation, hospital resource allocation, and payer coverage determinations for complex inpatient procedures. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.
Readers will find a concise clinical context for the procedure, common sites of service, and the typical service line implications for inpatient vascular surgery. The publication outlines payer coverage considerations and commonly reported modifiers (listed in the input) and identifies areas where coding clarity affects authorization and claim adjudication. Benchmarks and policy updates are summarized where available; when input data is missing for a particular element, the text indicates "Data not available in the input." The goal is to provide clinicians, billers, and policy analysts with a compact reference to support correct claim submission and administrative review for CPT code 35870.
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Billing Code Overview
CPT code 35870 describes a surgical procedure in which the provider corrects an abnormal opening (fistula) between a vascular graft and the intestines. This procedure involves repair or closure of the graft-enteric communication to control infection risk, hemorrhage, and loss of graft function.
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Service type: Surgical repair of graft-enteric fistula
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Typical site of service: Operating room or other inpatient surgical setting