Summary & Overview
CPT 35142: Open Repair of Ruptured Femoral Artery Aneurysm
CPT code 35142 represents open surgical repair of a ruptured femoral artery aneurysm, performed via a thigh incision with direct arterial repair or graft placement. This code captures a high-acuity vascular procedure with implications for inpatient surgical care, resource utilization, and post-operative management. Nationally, accurate coding of ruptured peripheral arterial aneurysm repairs supports appropriate payment, quality measurement, and tracking of emergent vascular services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common billing modifiers and operational notes, and guidance on where this service is typically delivered. The publication outlines how payers commonly approach coverage and payment for complex vascular surgery, highlights benchmarking considerations for inpatient surgical service lines, and summarizes coding nuances relevant to billing teams and hospital revenue cycle stakeholders.
This briefing is intended to help billing managers, clinical coders, and health policy analysts understand the clinical nature of the service, the typical sites where it is provided, and the payer landscape relevant to reimbursement and utilization measurement. Data not available in the input.
Billing Code Overview
CPT code 35142 describes a surgical procedure to repair a ruptured femoral artery aneurysm. The provider makes an incision in the thigh to access the femoral artery and then performs a direct arterial repair or places a vascular graft at the site of rupture.
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Service type: Vascular surgery, open repair of ruptured femoral artery aneurysm
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Typical site of service: Inpatient hospital operating room or other surgical suite providing open vascular procedures
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of hypertension and peripheral arterial disease presents to the emergency department with sudden-onset severe groin and thigh pain, expanding pulsatile mass in the right groin, hypotension, and falling hemoglobin. CT angiography confirms a ruptured right common femoral artery aneurysm with active extravasation. The vascular surgery team evaluates the patient, obtains informed consent, and proceeds to the operating room for urgent open repair.
The clinical workflow includes preoperative resuscitation and crossmatch, anesthesia evaluation (general or regional), surgical exposure via a longitudinal or transverse incision in the groin/thigh, proximal and distal vascular control, evacuation of hematoma, direct arterial repair or interposition graft placement (autologous vein or prosthetic), completion angiography or Doppler assessment, wound closure, and postoperative monitoring in a step-down or intensive care setting. The procedure may require blood transfusion, intraoperative consultation (e.g., urology if adjacent structures injured), and postoperative surveillance for graft patency and wound complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | For substantially greater work, complexity, or operative time than typical for 35142 due to extensive dissection or unexpected findings |