I71.32

Billable

Juxtarenal abdominal aortic aneurysm, 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 ruptured weakened, bulging area in the abdominal aorta located at the level of the renal arteries (juxtarenal region).

Coding Tips

•Juxtarenal means the aneurysm extends to or involves the renal artery level; this affects surgical approach
•Verify imaging documentation specifies juxtarenal location to distinguish from pararenal or infrarenal

Clinical Significance

Ruptured abdominal aortic aneurysm (juxtarenal) is a catastrophic vascular emergency with mortality rates of 80-90% overall, including prehospital deaths. Even with emergent surgical repair, operative mortality remains 40-50%. This condition causes massive retroperitoneal or intraperitoneal hemorrhage and hemodynamic collapse. Survivors face prolonged intensive care stays and significant postoperative complications, making this among the highest-acuity vascular diagnoses for risk adjustment.

Documentation Requirements

✓Ruptured abdominal aortic aneurysm documented — anatomical location: juxtarenal
✓Rupture confirmed by imaging (CT showing retroperitoneal hemorrhage, free fluid) or intraoperative findings
✓Aneurysm size at time of rupture documented
✓Hemodynamic status at presentation (hypotension, shock, resuscitation requirements)
✓Relationship to renal arteries documented (infrarenal, juxtarenal, pararenal, suprarenal) — critical for surgical planning and code specificity
✓Surgical intervention type (open repair vs. endovascular aortic repair) and findings
✓Postoperative complications documented (acute kidney injury, bowel ischemia, abdominal compartment syndrome)

Commonly Confused Codes

I71.40-I71.41 — Abdominal aortic aneurysm WITHOUT rupture (non-ruptured — dramatically different acuity and HCC mapping)I71.10-I71.13 — Thoracic aortic aneurysm, ruptured (different anatomical location — thoracic vs. abdominal)I71.02 — Dissection of abdominal aorta (dissection is intimal tear, not aneurysm rupture — different pathology)I71.5/I71.6 — Thoracoabdominal aortic aneurysm codes (use these when the aneurysm extends across both thoracic and abdominal segments)

Code Hierarchy

└I71Aortic aneurysm and dissection └I71.3Abdominal aortic aneurysm, ruptured └I71.32Juxtarenal abdominal aortic aneurysm, ruptured

└I71.32Juxtarenal abdominal aortic aneurysm, ruptured