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2025 CPT code 35092

Repair of ruptured abdominal aortic aneurysm involving visceral vessels.

Refer to CPT guidelines for specific coding instructions related to vascular procedures. Ensure that the documentation clearly identifies the involvement of visceral vessels to justify the use of 35092. Do not report separately for any endarterectomy performed as part of the procedure.

Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), bilateral procedures (50), or unusual circumstances (22). Proper documentation supporting the use of modifiers is crucial.

Medical necessity for 35092 is established by the presence of a ruptured abdominal aortic aneurysm involving visceral vessels, posing an immediate threat to the patient's life.The procedure aims to prevent exsanguination, ischemia to vital organs, and death.

The surgeon makes an incision in the abdomen, exposes the ruptured aneurysm, clamps the affected area to control bleeding, removes the damaged section of the aorta and visceral vessels, and inserts a graft to restore normal blood flow.A patch graft may also be used if necessary. The incision is then closed in layers.

In simple words: This procedure involves repairing a ruptured bulge (aneurysm) in the main artery of the abdomen (aorta) that extends to other vital arteries supplying organs like the intestines, liver, and kidneys. The surgeon opens the abdomen, removes the damaged part of the aorta, and replaces it with a new section (graft). Sometimes, a patch is also used to reinforce the repair.

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)

Example 1: A patient presents with sudden, severe abdominal pain and signs of shock due to a ruptured abdominal aortic aneurysm extending to the mesenteric artery.Code 35092 is used for the emergency repair., A patient with a known abdominal aortic aneurysm involving the celiac and renal arteries experiences rupture.The aneurysm is repaired using a graft and patch, requiring code 35092., A patient presents with a ruptured pseudoaneurysm of the abdominal aorta affecting the renal arteries. The surgeon excises the pseudoaneurysm and inserts a graft. This procedure is reported with 35092.

Documentation should include operative report detailing the location and extent of the ruptured aneurysm, involvement of visceral vessels, type of repair performed (direct repair, graft insertion, patch graft), intraoperative findings, and estimated blood loss. Preoperative imaging (CT, MRI, or angiography) confirming the diagnosis and extent of the aneurysm should also be documented.Post-operative notes detailing the patient's status, complications, and recovery progress are also necessary.

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