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Official Description

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 iliac vessels (common, hypogastric, external)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 35102 refers to the surgical procedure for the direct repair of an abdominal aortic aneurysm or pseudoaneurysm, particularly when there is involvement of the iliac vessels, which include the common, hypogastric, and external iliac arteries. An abdominal aortic aneurysm is characterized by an abnormal enlargement or dilation of the abdominal aorta, which can lead to serious complications if not addressed. Pseudoaneurysms, on the other hand, are not true aneurysms as they do not involve all three layers of the arterial wall; they typically arise from trauma or complications from medical procedures, resulting in a hematoma that communicates with the artery. The procedure involves either direct repair or excision of the aneurysm, followed by the insertion of a graft, which may or may not include a patch graft. This surgical intervention is crucial for patients with associated occlusive disease affecting the abdominal aorta and iliac vessels, as it aims to restore normal blood flow and prevent life-threatening complications. The surgery is performed through a midline abdominal incision, allowing access to the aorta, and involves meticulous steps to ensure the safe and effective repair of the affected vessels.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35102 is indicated for the following conditions:

  • Abdominal Aortic Aneurysm - An abnormal enlargement of the abdominal aorta that poses a risk of rupture.
  • Pseudoaneurysm - A hematoma that forms due to trauma or procedural complications, which communicates with the arterial lumen but does not involve all layers of the arterial wall.
  • Associated Occlusive Disease - Conditions that lead to blockage or narrowing of the arteries, particularly affecting the abdominal aorta and iliac vessels.

2. Procedure

The procedure for CPT® Code 35102 involves several critical steps to ensure the successful repair of the aneurysm or pseudoaneurysm:

  • Step 1: Incision - A midline abdominal, transverse, or retroperitoneal flank incision is made to gain access to the abdominal aorta. This incision allows the surgeon to navigate through the overlying soft tissues to reach the aorta.
  • Step 2: Exposure - The duodenum is carefully dissected away from the aorta to expose the vessel adequately. This step is crucial for visualizing the aorta and the surrounding structures.
  • Step 3: Control of Blood Flow - Proximal control is established below the renal arteries, and distal control is achieved beyond the iliac artery aneurysm. This ensures that blood flow can be managed effectively during the repair.
  • Step 4: Clamping - The iliac arteries are clamped below the level of the aneurysm, and the proximal aorta is also clamped to prevent blood loss during the procedure.
  • Step 5: Aneurysm Sac Management - The aneurysm sac is opened longitudinally, and any thrombus present within the aorta is removed. This step is essential for preparing the site for graft placement.
  • Step 6: Oversewing of Arteries - The lumbar arteries and the inferior mesenteric artery are oversewn to prevent bleeding and ensure proper closure of the aorta.
  • Step 7: Graft Insertion - A synthetic iliac bifurcation graft is sutured to the healthy aorta proximal to the aneurysm and to the healthy iliac artery distal to the aneurysm. This graft serves to restore normal blood flow through the affected vessels.
  • Step 8: Closure - After the graft is securely placed, the aneurysm sac is closed over the graft. The clamps are then released to re-establish blood flow through the newly placed graft.
  • Step 9: Final Repair - The retroperitoneum is repaired, and the abdominal incision is closed, completing the procedure.

3. Post-Procedure

Post-procedure care following the repair of an abdominal aortic aneurysm or pseudoaneurysm involves monitoring the patient for any signs of complications, such as bleeding or infection. Patients are typically observed in a recovery area before being transferred to a hospital room for further monitoring. Pain management is provided as needed, and the surgical site is assessed for proper healing. Follow-up imaging may be required to ensure the integrity of the graft and to monitor for any potential complications. Patients are usually advised on activity restrictions and follow-up appointments to ensure a successful recovery.

Short Descr REPAIR DEFECT OF ARTERY
Medium Descr DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS
Long Descr 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 iliac vessels (common, hypogastric, external)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2B - Major procedure, cardiovascular-Aneurysm repair
MUE 1
CCS Clinical Classification 52 - Aortic resection, replacement or anastomosis

This is a primary code that can be used with these additional add-on codes.

35572 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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