How To Use CPT Code 35091

CPT 35091 describes the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, for aneurysm, pseudoaneurysm, and associated occlusive disease in the abdominal aorta involving visceral vessels. 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 35091?

CPT 35091 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, in the abdominal aorta involving visceral vessels. This procedure is performed to treat aneurysms, pseudoaneurysms, and associated occlusive diseases in the abdominal aorta and its branches.

2. Official Description

The official description of CPT code 35091 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, abdominal aorta involving visceral vessels (mesenteric, celiac, renal).’ This code includes the repair of aneurysms, pseudoaneurysms, and associated occlusive diseases in the abdominal aorta and its branches.

3. Procedure

1. The surgeon makes an incision into the abdomen to access the aneurysm or pseudoaneurysm in the abdominal aorta and visceral vessels.
2. The surgeon identifies the exact location of the aneurysm or pseudoaneurysm and clamps the proximal and distal ends of the affected vessel.
3. The surgeon performs direct repair by excising the aneurysm or pseudoaneurysm and suturing the remaining ends of the artery together.
4. If necessary, the surgeon may insert a graft to fill in the gap created in the artery or place a patch graft to cover an open area and improve blood flow.
5. The surgeon closes the incision with sutures in layers.

4. Qualifying circumstances

CPT 35091 is performed on patients with aneurysms, pseudoaneurysms, and associated occlusive diseases in the abdominal aorta involving visceral vessels. The procedure is typically performed by a surgeon and may require the use of grafts or patch grafts to repair the affected vessels.

5. When to use CPT code 35091

CPT code 35091 should be used when a surgeon performs a direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, in the abdominal aorta involving visceral vessels. This code is appropriate for cases where the repair is performed for aneurysms, pseudoaneurysms, and associated occlusive diseases in the abdominal aorta and its branches.

6. Documentation requirements

To support a claim for CPT 35091, the surgeon must document the following information:

• Patient’s diagnosis of aneurysm, pseudoaneurysm, or associated occlusive disease
• Description of the procedure performed, including whether a graft or patch graft was used
• Date of the procedure
• Details of the repair, including the location of the aneurysm or pseudoaneurysm and the method of repair
• Any complications or additional procedures performed
• Signature of the surgeon

7. Billing guidelines

When billing for CPT 35091, ensure that the procedure meets the criteria for this code, including the repair of aneurysms, pseudoaneurysms, and associated occlusive diseases in the abdominal aorta involving visceral vessels. It is important to follow the specific documentation requirements and guidelines provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 35091 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A surgeon performs a direct repair of an abdominal aortic aneurysm with graft insertion for a patient with associated occlusive disease.
2. A patient undergoes a partial excision of a pseudoaneurysm in the renal artery with patch graft placement.
3. A surgeon performs a total excision of an aneurysm in the mesenteric artery and performs a direct repair without the use of a graft.
4. A patient with an abdominal aortic pseudoaneurysm and associated occlusive disease undergoes a direct repair with graft insertion and patch graft placement.
5. A surgeon performs a direct repair of an aneurysm in the celiac trunk with graft insertion for a patient with associated occlusive disease.
6. A patient undergoes a partial excision of a pseudoaneurysm in the renal artery without the use of a graft.
7. A surgeon performs a total excision of an aneurysm in the mesenteric artery and performs a direct repair with graft insertion.