How To Use CPT Code 35111

CPT 35111 describes the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion in the splenic 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 35111?

CPT 35111 is used to describe the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion in the splenic artery. This code is used when a provider makes an incision in the abdomen to access the aneurysm or pseudoaneurysm in the splenic artery and performs the necessary repair or graft insertion.

2. Official Description

The official description of CPT code 35111 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, splenic artery.’

3. Procedure

1. The provider makes an incision in the abdomen to access the aneurysm or pseudoaneurysm in the splenic artery.
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 or help widen the artery.
4. The provider closes the incision with sutures in layers.

4. Qualifying circumstances

CPT 35111 is performed when there is an aneurysm, pseudoaneurysm, or associated occlusive disease in the splenic artery that requires direct repair or graft insertion. The procedure is typically performed by a qualified healthcare provider who has the necessary expertise in vascular surgery.

5. When to use CPT code 35111

CPT code 35111 should be used when a provider performs the direct repair of an aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion in the splenic artery. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 35111, the provider must document the following information:

• Patient’s diagnosis and the need for direct repair or graft insertion
• Details of the procedure performed, including the incision site and any additional repairs or graft insertions
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 35111, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any specific billing requirements from insurance providers or government payers.

8. Historical information

CPT code 35111 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition. However, it is important to stay updated with any changes or revisions to the code in future code sets.

9. Examples

1. A vascular surgeon performs a direct repair of an aneurysm in the splenic artery for a patient with a diagnosed splenic artery aneurysm.
2. A patient with a pseudoaneurysm in the splenic artery undergoes a procedure in which a graft is inserted to repair the defect.
3. A provider performs an excision and graft insertion in the splenic artery to treat an occlusive disease associated with an aneurysm.
4. A patient with a splenic artery pseudoaneurysm undergoes a partial excision and graft insertion procedure to repair the defect.
5. A provider performs a total excision and graft insertion in the splenic artery to treat a large aneurysm.
6. A patient with an associated occlusive disease in the splenic artery undergoes a direct repair and patch graft insertion procedure.
7. A provider performs a direct repair and graft insertion in the splenic artery for a patient with a ruptured aneurysm.
8. A patient with a splenic artery pseudoaneurysm undergoes a direct repair and patch graft insertion procedure to prevent rupture.
9. A provider performs a direct repair and graft insertion in the splenic artery for a patient with a diagnosed splenic artery aneurysm and associated occlusive disease.
10. A patient with a large aneurysm in the splenic artery undergoes a direct repair and graft insertion procedure to prevent rupture and restore blood flow.