Neurosurgery Coding Alert

Reader Question:

Choose 35301 for Endarterectomy

Question: What are the proper codes for carotid endarterectomy?

Washington, D.C., Subscriber Answer: The only available code for carotid endarterectomy is 35301 (Thromboendarterectomy, with or without patch graft; carotid, vertebral, subclavian, by neck incision). The procedure serves to prevent stroke by removing atherosclerotic plaque, which causes narrowing of blood vessels, from the carotid artery (the main artery carrying blood to the head).
 
During the procedure, the surgeon exposes the carotid artery through an incision in the side of the neck. The surgeon clamps the artery on either side of the affected area, opens the artery, removes the plaque and then sutures the artery closed. If the carotid endarterectomy is a repeat procedure more than one month after the initial operation, you should also bill - and be paid for - add-on code +35390 (Reoperation, carotid, thromboendarterectomy, more than one month after original operation [list separately in addition to code for primary procedure]).
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