2025 CPT code 35022
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Direct repair of a ruptured aneurysm in the innominate or subclavian artery via a thoracic incision, including graft insertion with or without a patch graft.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services, etc.).
Medical necessity is established by the presence of a life-threatening condition (ruptured aneurysm) requiring immediate surgical intervention to prevent further complications such as hemorrhage, stroke, or death.Documentation must clearly demonstrate the urgency of the situation and the need for immediate repair.
The surgeon is responsible for all aspects of the procedure, from incision and dissection to repair and closure. This includes locating the aneurysm, clamping the vessel, excising the aneurysmal portion, performing the repair (either direct suture or graft placement), and closing the incision.
In simple words: The doctor makes a cut in the chest to reach a burst blood vessel (aneurysm) in the upper chest.They then either sew the blood vessel back together or use a patch or a small tube (graft) to repair it.
This procedure involves a lateral thoracotomy incision to access a ruptured aneurysm in the innominate or subclavian artery.The surgeon dissects the surrounding structures, clamps the proximal and distal ends of the aneurysm, and excises the aneurysmal portion.The remaining artery ends are then directly repaired by suture or using a graft to fill the defect. A patch graft may also be used. The incision is closed in layers.
Example 1: A 65-year-old male presents with sudden onset of chest pain and shortness of breath.Imaging reveals a ruptured aneurysm in the right subclavian artery.A lateral thoracotomy is performed, and the aneurysm is repaired using a Dacron graft., A 72-year-old female with a history of hypertension experiences sudden left arm weakness and numbness.A CT scan shows a ruptured aneurysm in the innominate artery.The patient undergoes a left thoracotomy, and the aneurysm is repaired with a direct suture repair., An 80-year-old male with a known history of atherosclerosis is admitted after a syncopal episode.Angiography reveals a ruptured aneurysm in the left subclavian artery.Surgical repair is undertaken with a patch graft.
Preoperative imaging (CT, MRI, or angiography) demonstrating the aneurysm.Operative report detailing the surgical approach, repair technique (direct suture or graft), and any complications.Pathology report if tissue is sent for analysis.Postoperative imaging to confirm the repair.
** Thorough documentation is crucial for appropriate coding and reimbursement.Any variations from the standard procedure should be clearly documented in the operative report.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center