June 22, 2017
Our hand surgeon recently took a patient to surgery for what he thought was a cyst in the forearm. After making his incision and exploring the area, the surgeon found an aneurysm in the ulnar artery. He resected the aneurysm and repaired the defect with a vein graft harvested from the arm. We could not find a code for this in the musculoskeletal section of CPT.
Thanks for contacting KZA! This is a great example of having to look outside the daily world in which we find so much comfort. The answer lies in the vascular section (3xxxx) section of the CPT manual. The correct code based on the question, and thank you, the review of the operative note, is CPT code 35045 (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, radial or ulnar artery). This CPT code includes the resection of the aneurysm and the harvest and insertion of the vein graft in your scenario for the repair of the defect.
*This response is based on the best information available as of 06/22/17.