How To Use CPT Code 35103

CPT code 35103 describes the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft, for a ruptured aneurysm in the abdominal aorta involving iliac 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 35103?

CPT 35103 can be used to describe the direct repair of a ruptured aneurysm in the abdominal aorta involving iliac vessels. This code is used when the provider performs an excision or partial/total removal of the aneurysm and inserts a graft, with or without a patch graft, to repair the defect.

2. Official Description

The official description of CPT code 35103 is: ‘Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external).’

3. Procedure

1. The provider makes an incision into the abdomen and pelvis to access the ruptured aneurysm in the abdominal aorta and iliac vessels.
2. The provider performs direct repair or places a graft at the site of repair.
3. If necessary, the provider may also place a patch graft to cover an open area on one side of the vessel or help widen the artery.
4. The provider closes the incision with sutures in layers.

4. Qualifying circumstances

Patients eligible to receive CPT 35103 services are those with a ruptured aneurysm in the abdominal aorta involving iliac vessels. The provider must perform a direct repair, excision (partial or total), and graft insertion, with or without a patch graft, to repair the aneurysm. The procedure must be performed on the abdominal aorta and iliac vessels.

5. When to use CPT code 35103

CPT code 35103 should be used when the provider performs a direct repair of a ruptured aneurysm in the abdominal aorta involving iliac vessels. This code should be used for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT 35103, the provider must document the following information:

• Patient’s diagnosis of a ruptured aneurysm in the abdominal aorta involving iliac vessels
• Details of the procedure performed, including the type of repair, excision, graft insertion, and the use of a patch graft
• Date of the procedure
• Any additional relevant information, such as the size of the aneurysm or any complications encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 35103, ensure that the provider performs a direct repair of a ruptured aneurysm in the abdominal aorta involving iliac vessels. Use the appropriate CPT code based on the specific procedure performed. There are no specific guidelines regarding reporting CPT code 35103 with other codes.

8. Historical information

CPT 35103 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition. It was also added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a direct repair of a ruptured aneurysm in the abdominal aorta involving iliac vessels for a patient who presents with severe abdominal pain and signs of internal bleeding.
2. A patient with a known abdominal aortic aneurysm experiences a rupture, and the provider performs a direct repair with graft insertion to stop the bleeding and stabilize the patient.
3. A provider performs a partial excision of a ruptured aneurysm in the abdominal aorta involving iliac vessels and inserts a graft to repair the defect.
4. A patient presents with a pseudoaneurysm in the abdominal aorta involving iliac vessels, and the provider performs a direct repair with graft insertion to prevent further complications.
5. A provider performs a total excision of a ruptured aneurysm in the abdominal aorta involving iliac vessels and places a patch graft to cover the open area and ensure proper blood flow.
6. A patient with a history of abdominal aortic aneurysm experiences a rupture, and the provider performs a direct repair with graft insertion and patch graft to repair the defect and prevent future complications.
7. A provider performs a direct repair of a ruptured aneurysm in the abdominal aorta involving iliac vessels for a patient who presents with hypotension and signs of shock.
8. A patient with a known abdominal aortic aneurysm presents with a ruptured aneurysm, and the provider performs a direct repair with graft insertion and patch graft to ensure proper blood flow and prevent further complications.