I71.12

Billable

Aneurysm of the aortic arch, ruptured

HCC Category Mapping

V28HCC 264 — Vascular Disease with Complications

0.356

V24HCC 107 — Vascular Disease with Complications

0.450

ESRDHCC 107 — Vascular Disease with Complications

0.000

What This Code Means

A burst or ruptured bulging, weakened area in the aortic arch (the curved portion of the main artery).

Coding Tips

•Arch aneurysm ruptures are particularly complex due to proximity to major branch vessels; document all involved structures
•Ensure rupture status is clearly documented to distinguish from contained ruptures

Clinical Significance

Ruptured thoracic aortic aneurysm (aortic arch) is a surgical emergency with extremely high mortality — estimated at 50-80% overall, with many patients dying before reaching the hospital. Rupture represents catastrophic failure of the aortic wall, causing massive hemorrhage into the mediastinum, pleural space, or pericardium. Survivors require emergent surgical repair and intensive postoperative care, making this one of the most resource-intensive vascular diagnoses for risk adjustment.

Documentation Requirements

✓Ruptured thoracic aortic aneurysm explicitly documented — location: aortic arch
✓Rupture confirmed by imaging (CT angiography showing extravasation or contained rupture) or surgical findings
✓Aneurysm size documented prior to or at time of rupture
✓Acute presentation documented with hemodynamic compromise or hemorrhagic shock
✓Surgical intervention documented (open repair, endovascular repair with thoracic endovascular aortic repair)
✓Associated complications documented (hemothorax, cardiac tamponade, aortic dissection if concurrent)

Commonly Confused Codes

I71.20-I71.23 — Thoracic aortic aneurysm WITHOUT rupture (critical distinction — ruptured vs. non-ruptured significantly affects acuity and coding)I71.00-I71.03 — Aortic dissection (dissection involves intimal tear creating false lumen; rupture involves full-thickness aortic wall failure)I71.30-I71.33 — Abdominal aortic aneurysm, ruptured (different anatomical location — abdominal vs. thoracic)I71.03 — Thoracoabdominal dissection (dissection, not aneurysm rupture)

Code Hierarchy

└I71Aortic aneurysm and dissection └I71.1Thoracic aortic aneurysm, ruptured └I71.12Aneurysm of the aortic arch, ruptured

└I71.12Aneurysm of the aortic arch, ruptured