2025 CPT code 35021
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on Arteries and Veins - Vascular Surgery Surgery Feed
Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision.
Modifiers may be applicable depending on the circumstances.For example, modifier 51 (multiple procedures) might be used if other procedures are performed during the same operative session.Modifier 59 may be used to indicate a distinct procedural service if the clinical context warrants such separation.Consult the CPT guidelines and your specific payer's instructions for modifier usage.
Medical necessity for this procedure is established when the aneurysm or pseudoaneurysm poses a significant risk of rupture, causing life-threatening hemorrhage, or when it causes clinically significant symptoms such as pain, ischemia, or neurological compromise.
The vascular surgeon is responsible for all aspects of the procedure, including pre-operative planning, intra-operative management, and post-operative follow-up. Anesthesiologist, surgical technicians, and other supporting medical personnel also contribute to the patient care.
In simple words: This code describes a chest surgery to fix a weakened or bulging area (aneurysm) or a tear (pseudoaneurysm) in a major artery near the collarbone. The surgeon will repair the damaged area and replace it with a graft (a piece of healthy artery or artificial material) to restore normal blood flow.A patch may also be used.
This CPT code encompasses the direct surgical repair of an aneurysm or pseudoaneurysm in the innominate or subclavian artery, approached via a thoracic incision.The procedure involves excision (partial or total) of the affected area, followed by graft insertion to restore vessel integrity.A patch graft may also be utilized. This code is applicable to cases involving aneurysm, pseudoaneurysm, or associated occlusive disease.
Example 1: A 65-year-old male patient presents with a symptomatic pseudoaneurysm of the right subclavian artery. A thoracic incision is made, the pseudoaneurysm is excised, and a Dacron graft is inserted. , A 72-year-old female presents with a large, asymptomatic aneurysm of the innominate artery found during routine imaging.A thoracic incision is used for the repair of the aneurysm, utilizing an autologous saphenous vein graft. , A 58-year-old male presents after a motor vehicle accident with a ruptured innominate artery aneurysm. An emergency thoracotomy is performed, and a synthetic graft is used to repair the rupture and associated occlusive disease.
** Thorough documentation is crucial for proper reimbursement.Accurate coding requires precise description of the surgical approach, type of repair, graft material used, and presence of any complications.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: This information is payer-specific and varies significantly. Consult the specific payer's fee schedule for RVU values and reimbursement rates (including facility and non-facility rates).
- Global Days: The global period for this procedure is typically 90 days, encompassing pre-operative, operative, and post-operative care. However, this can vary based on payer policies and individual case circumstances. Always refer to payer guidelines.
- Payment Status: Active
- Modifier TC rule: This procedure may involve separate technical and professional components depending on billing practices, payer policies and the nature of the services rendered. Review your payer’s guidelines to determine any modifier requirements for the professional and technical components.
- Fee Schedule: Historical fee schedule information is not consistently available in a centralized format. The reimbursement for this procedure is highly variable and dependent on multiple factors, such as payer, geographic location, facility status, and the complexity of the case.Consult fee schedules and payment policies from individual payers for specific historical data.
- Specialties:Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center