How To Use CPT Code 35045

CPT 35045 describes the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, specifically for the radial or ulnar artery. 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 35045?

CPT 35045 is used to describe the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, specifically for the radial or ulnar artery. This code is used when the provider makes an incision in the arm to access the aneurysm or pseudoaneurysm in the radial or ulnar artery and performs the necessary repair or graft insertion.

2. Official Description

The official description of CPT code 35045 is: ‘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, radial or ulnar artery.’

3. Procedure

1. The provider prepares the patient and makes an incision in the arm to access the aneurysm or pseudoaneurysm in the radial or ulnar artery.
2. The provider locates the exact site of the aneurysm or pseudoaneurysm by dissecting the surrounding structures.
3. The provider clamps the proximal and distal ends of the aneurysm or pseudoaneurysm.
4. The provider performs the necessary repair or excision of the aneurysm or pseudoaneurysm.
5. If needed, the provider places a graft to fill in the gap created in the artery.
6. The provider may also place a patch graft to cover an open area on one side of the vessel or help widen the artery and improve blood flow.
7. The provider sutures the remaining ends of the artery together or closes the incision with sutures in layers.

4. Qualifying circumstances

CPT 35045 is used for patients with aneurysms, pseudoaneurysms, or associated occlusive disease in the radial or ulnar artery. The procedure is performed by a provider who directly repairs the aneurysm or pseudoaneurysm and may insert a graft or patch graft. The specific qualifying circumstances may vary depending on the patient’s condition and the provider’s clinical judgment.

5. When to use CPT code 35045

CPT code 35045 should be used when the provider performs a direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, specifically for the radial or ulnar artery. This code is appropriate when the procedure meets the criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 35045, the provider must document the following information:

• Patient’s diagnosis of aneurysm, pseudoaneurysm, or associated occlusive disease
• Details of the procedure performed, including the specific repair, graft insertion, or patch graft
• Date of the procedure
• Incision site and approach
• Any additional relevant details or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 35045, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately report the specific repair, graft insertion, or patch graft performed. Follow the appropriate coding guidelines and modifiers as required by the payer. It is also important to review any specific billing guidelines provided by the payer or relevant coding authorities.

8. Historical information

CPT 35045 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 and terminology related to aneurysms and pseudoaneurysms.

9. Examples

1. A provider performs a direct repair of an aneurysm in the radial artery, inserting a graft to restore blood flow.
2. A patient presents with a pseudoaneurysm in the ulnar artery, and the provider performs an excision and patch graft to repair the defect.
3. A provider performs a partial excision of an aneurysm in the radial artery and inserts a patch graft to improve blood flow.
4. A patient with an associated occlusive disease in the ulnar artery undergoes a total excision and graft insertion to restore blood flow.