2025 CPT code 33886
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Endovascular Repair Procedures of the Descending Thoracic Aorta Surgery Feed
Placement of distal extension prosthesis(s) delayed after endovascular repair of the descending thoracic aorta.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for appropriate modifier usage.
Medical necessity for this procedure is established by the presence of a clinically significant endoleak following an initial endovascular repair of the descending thoracic aorta.The endoleak must pose a significant risk of rupture or other complications.Documentation must support the diagnosis and the need for the procedure.
The clinical responsibility involves pre-operative evaluation, obtaining informed consent, performing the procedure (including arteriography, guidewire placement, prosthesis deployment and balloon angioplasty if necessary), intraoperative imaging and monitoring, post-operative care, and follow-up. This includes managing complications, interpretation of images and ensuring appropriate prosthesis placement and leak closure.
In simple words: The doctor places additional small pieces of a graft (a tube-like device) into a previously repaired artery in the chest to seal a leak. This is done to fix a problem after an earlier surgery to repair a weakened or damaged area of this artery.
This CPT code, 33886, reports the placement of one or more distal extension prostheses in the descending thoracic aorta.This procedure is typically performed after an initial endovascular repair of the descending thoracic aorta to address an endoleak.The endoleak may result from various underlying conditions such as aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption.The procedure involves the introduction of the distal extension component(s) via a guidewire, typically through a femoral artery access site, and deployment under fluoroscopic guidance.Balloon angioplasty may be used to ensure proper seating and sealing of the prosthesis.Imaging is used to confirm the position and effectiveness of the prosthesis placement. Note that this code is reported only once, regardless of the number of modules deployed, and should not be reported with codes 33880 or 33881.
Example 1: A 70-year-old male patient presents with an endoleak after an endovascular aortic repair (EVAR) of a descending thoracic aortic aneurysm.The endoleak is type II, originating from a branch vessel.A distal extension is placed to seal the leak., A 65-year-old female patient undergoes an EVAR for a descending thoracic aortic dissection.Post-operative imaging reveals a type I endoleak.Multiple distal extensions are used to repair the endoleak, which are coded with 33886 reported only once., A 55-year-old male patient with a history of trauma to the descending thoracic aorta undergoes EVAR. The patient develops a type III endoleak post-procedure. The placement of a distal extension is required to seal this leak. This is coded as 33886.
Pre-operative assessment including medical history, physical examination, and relevant imaging studies (CT scan, MRI).Informed consent documentation.Operative report detailing the approach, technique, and materials used.Intraoperative imaging (fluoroscopy).Post-operative imaging to confirm the successful repair of the endoleak.Patient's course, including any complications.
** The provided text indicates approximately 100 edits exist for this code.Always refer to the most up-to-date payer guidelines and NCCI edits to ensure accurate coding and reimbursement.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided source.Refer to the CMS fee schedule for the most up-to-date RVU values and reimbursement rates.
- Global Days: The global period for this procedure is not specified in the provided source.The global period is determined by the payer and may vary.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a complete procedure code.
- Fee Schedule: Historical fee schedule data is not provided. Refer to publicly available fee schedules from payers.
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center