Abdominal Aortic Stent Grafting - Number of limbs?

JenReyn99

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So I want to just check in with you all on this, and make sure I'm understanding and coding these correctly. Here is an example of a typical report I receive, please give me your opinions on CPT codes and how you determined the number of limbs. It seems like my docs are calling things "limbs" that may not actually be matching up with the language for code selection. Any help is appreciated. Thanks!

"both common femoral arteries were punctured. 11 French Sheath was placed on each side. A 5 French pigtail catheter was placed in the abdominal aorta above the renal arteries. Films of the abdominal aorta were obtained.

Catheter was then moved to the opposite side. The main body device of the stent graft was then deployed on the right side. Stent graft is a Endurant II graft. The top of the graft is 32 mm at the top and 10.3 cm in length. The pigtail catheter was removed. The gate was then cannulated. A wire was then placed through the gate. Films were obtained of the left iliac artery through the sheath. The contralateral limb was then deployed in an overlapping fashion. This component measures 16mm at the top and 20 mm at the bottom and 15.6 cm in length. The rest of the main body graft was then deployed. The main body device was then removed and a sheath was placed.

Films were obtained through the sheath of the right side. An ipsilateral limb was then deployed in overlapping fashion. This component measures 16 mm at the top and 20 mm at the bottom and 12.4 cm in length.

The main body and both limbs were then dilated with a Reliant balloon. A stenosis was encountered in the right common iliac artery. This was dilated with a high pressure 12x40 mm balloon. The pigtail catheter was placed above the sent graft. An abdominal aortogram was then obtained. The catheters were removed. "

Any help/insight is greatly appreciated.
 

Chlrtrep

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IMHO

There are a few different types of AAA stent.

tubular, bifurcated (with one docking limb), bifurcated(2 docking limbs), unibody.

CPT 34802
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (1 docking limb)

The Endurant is a bifurcated prosthesis with one docking limb

This main portion of this stent covers the abdominal aorta area and one iliac, it then requires the docking limb to be in other iliac (contralateral side) to complete the stent. CPT 34802 includes all of this main body and docking limb. Any additional extensions are then code separately as appropriate.


I believe this is what your physician is describing.

Our physician generally state for example docking limb placed on contra-lateral side .

HTH
 

madcomic2000

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If you are using a Medtronic graft, those are 34802. Cook-Zenith grafts are 34803. Endologix grafts are 34804. Usually each company who makes them has there own type of graft that they do.
 
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