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2025 CPT code 35021

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.

Always refer to the official CPT coding guidelines published by the AMA.Ensure accurate coding and documentation, specifying the type of graft used, any complications, and the use of patch grafts.

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.

IMPORTANT:For ruptured aneurysms, consider 35022. For intracranial aneurysms, refer to codes 61700 and following.For endovascular repair, refer to appropriate code ranges (e.g., 34701-34716 for abdominal aortic aneurysms).

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.

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