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The CPT® Code 35132 refers to the surgical procedure for the direct repair of a ruptured aneurysm or pseudoaneurysm of the iliac artery, which includes the common, hypogastric, and external iliac branches. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can occur due to various factors such as arteriosclerosis, mechanical obstruction, or malposition of the artery. Less frequently, conditions like syphilis, tuberculosis, or abnormalities in the vessel wall, such as fibromuscular dysplasia, may also contribute to the formation of an aneurysm. In contrast, a pseudoaneurysm is a hematoma that forms in communication with the artery wall but does not involve all three layers of the arterial wall, typically resulting from trauma or complications from medical procedures like catheterization. The procedure involves accessing the iliac artery through a lower abdominal and/or leg incision, followed by the division of overlying soft tissues to expose the artery. Control of the iliac artery is established both above and below the aneurysm, and anticoagulation is administered prior to clamping the artery. The aneurysm sac is then opened to remove any thrombus and plaque, and the artery walls are repaired with sutures. Depending on the specific circumstances, a patch graft may be applied, or the aneurysm may be excised with direct repair through end-to-end anastomosis of the vessel ends. Alternatively, a tube graft may be inserted, which involves making a longitudinal incision in the artery and suturing the graft to healthy artery segments. This procedure is classified as an emergency intervention due to the nature of the ruptured aneurysm, necessitating immediate control of bleeding before repair can be performed.
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The procedure described by CPT® Code 35132 is indicated for the surgical repair of a ruptured aneurysm or pseudoaneurysm of the iliac artery. The following conditions may warrant this intervention:
The procedure for CPT® Code 35132 involves several critical steps to ensure the successful repair of the ruptured aneurysm or pseudoaneurysm:
Post-procedure care following the surgical repair of a ruptured aneurysm or pseudoaneurysm includes monitoring for any signs of complications such as bleeding, infection, or graft failure. Patients may require hospitalization for observation and management of their recovery. Follow-up imaging studies may be necessary to assess the integrity of the repair and ensure proper healing. Additionally, patients may be advised on lifestyle modifications and medications to manage underlying conditions that contributed to the aneurysm formation.
| Short Descr | REPAIR ARTERY RUPTURE GROIN | Medium Descr | DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY | Long Descr | Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (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) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
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) |
| 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). | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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