How To Use CPT Code 35011

CPT 35011 describes the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, for aneurysm and associated occlusive disease in the axillary-brachial artery, performed through an incision in the arm. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 35011?

CPT 35011 is used to describe a surgical procedure that involves the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, for aneurysm and associated occlusive disease in the axillary-brachial artery. This procedure is performed through an incision in the arm to access the target area of the artery.

2. Official Description

The official description of CPT code 35011 is: ‘Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision.’

3. Procedure

1. The surgeon makes an incision in the arm to access the axillary-brachial artery.
2. The surrounding structures are dissected to expose the artery.
3. The surgeon clips the ends of the aneurysm or pseudoaneurysm.
4. The defect is repaired by excising the affected area.
5. The remaining ends of the artery are sutured together, or a graft is placed to fill in the gap created in the artery.
6. A patch graft may be used to cover an open area on one side of the vessel or widen the artery to improve blood flow.
7. The incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 35011 is performed on patients with aneurysm or pseudoaneurysm in the axillary-brachial artery, along with associated occlusive disease. The procedure is indicated when direct repair or excision, with or without graft insertion, is necessary to treat the condition. The incision is made in the arm to access the target area of the artery.

5. When to use CPT code 35011

CPT code 35011 should be used when a direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, is performed in the axillary-brachial artery through an incision in the arm. This code is appropriate for cases where the procedure is necessary to treat aneurysm and associated occlusive disease in the specified artery.

6. Documentation requirements

To support a claim for CPT 35011, the following documentation is required:

• Patient’s diagnosis of aneurysm or pseudoaneurysm in the axillary-brachial artery
• Description of the procedure performed, including details of the repair, excision, graft insertion, and use of patch graft if applicable
• Date of the procedure
• Incision site and approach used
• Any additional relevant details or findings during the procedure
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 35011, ensure that the procedure meets the criteria specified in the code description. The incision should be made in the arm to access the axillary-brachial artery. It is important to follow the appropriate coding guidelines and documentation requirements for accurate billing. CPT code 35011 should not be reported with other codes unless specifically indicated. It is recommended to review the specific billing guidelines and requirements of the payer to ensure proper reimbursement.

8. Historical information

CPT code 35011 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2002, which updated the description to include the term “false aneurysm” in addition to “pseudoaneurysm.”

9. Examples

1. A surgeon performs a direct repair of an aneurysm in the axillary-brachial artery through an incision in the arm.
2. An interventional radiologist excises a pseudoaneurysm in the axillary-brachial artery and inserts a graft to restore blood flow.
3. A vascular surgeon performs a partial excision and graft insertion for an aneurysm in the axillary-brachial artery, using a patch graft to reinforce the repair.
4. A cardiothoracic surgeon performs a total excision and graft insertion for an aneurysm in the axillary-brachial artery, without the need for a patch graft.