Cardiology Coding Alert

Reader Question:

Pull 34701 out of Your Coding Arsenal for This Scenario

Question: The patient had an infrarenal aorta aneurysm that had not ruptured, and the cardiologist used an aortic tube endograft to repair the vessel. This procedure involved additional stenting in the patient's right renal artery. What CPT® code should we report?

Virginia Subscriber

Answer: You should report 34701 (Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)).

Code 34701 is similar to 34702 (...for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)), but you should reserve this code for a rupture. You should not report any additional codes for the service you describe, even for additional stenting.

Here's why:  The endograft codes include each of these components: the pre-procedure computerized mapping involved in sizing and device selection; the catheterization; the radiological supervision and interpretation; and the endograft itself.