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The CPT® Code 35151 refers to the surgical procedure for the direct repair of an aneurysm or pseudoaneurysm of the popliteal artery, which may also involve excision (either partial or total) and the insertion of a graft, with or without the use of a patch graft. An aneurysm is defined as 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, aneurysms may arise from conditions like syphilis, tuberculosis, or abnormalities in the vessel wall, such as fibromuscular dysplasia. In contrast, a pseudoaneurysm is characterized by not involving all three layers of the artery wall and is often the result of trauma—either blunt or penetrating—or complications from medical procedures, such as catheterization. This condition leads to the formation of a pulsating hematoma that is encapsulated and communicates directly with the artery wall. The popliteal artery, which is a continuation of the common femoral artery, begins at the popliteal space behind the knee and bifurcates into the anterior and posterior tibial arteries. During the procedure, a surgical incision is made in the leg to access the popliteal artery, followed by the division of overlying soft tissues to expose the artery. Control of the popliteal artery is established both above and below the aneurysm, and after administering anticoagulants, the artery is clamped to facilitate the repair. The aneurysm sac is then opened to remove any thrombus and plaque, and the artery walls are sutured. Depending on the specific case, a graft may be applied, which can be either an autogenous graft (using the saphenous vein) or a synthetic patch graft. Alternatively, the aneurysm may be excised with direct repair through end-to-end anastomosis or by placing a tube graft. This procedure is performed in a nonemergent, elective setting, distinguishing it from the emergency procedure described by CPT® Code 35152, which pertains to the repair of a ruptured aneurysm.
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The procedure described by CPT® Code 35151 is indicated for the surgical repair of the following conditions:
The procedure for CPT® Code 35151 involves several critical steps to ensure the successful repair of the aneurysm or pseudoaneurysm:
Post-procedure care following the repair of an aneurysm or pseudoaneurysm of the popliteal artery includes monitoring for any signs of complications, such as bleeding or infection at the surgical site. Patients may require follow-up imaging studies to assess the integrity of the repair and ensure proper blood flow through the popliteal artery. Additionally, pain management and rehabilitation may be necessary to support recovery and restore function in the affected leg. It is important for healthcare providers to provide clear instructions regarding activity restrictions and signs of potential complications that patients should be aware of during their recovery period.
Short Descr | REPAIR DEFECT OF ARTERY | Medium Descr | DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY | 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, popliteal artery | 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) |
LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | RT | Right side (used to identify procedures performed on the right side of the body) |
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Notes
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2013-01-01 | Changed | Medium Descriptor changed. |
2002-01-01 | Changed | Code description changed. |
Pre-1990 | Added | Code added. |
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