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2025 CPT code 34706

Endovascular repair of infrarenal aorta and iliac arteries using an aorto-bi-iliac endograft for rupture.

Follow current CPT coding guidelines for endovascular aneurysm repair, paying close attention to the definition of the treatment zone and the inclusion/exclusion of additional procedures.

Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 50 may be used for bilateral procedures, and other modifiers may be used for anesthesia or assistants.

The procedure is medically necessary when a patient has an infrarenal aortic aneurysm or iliac artery pathology (aneurysm, pseudoaneurysm, dissection, etc.) that poses a significant risk of rupture or other life-threatening complications.The endovascular approach is preferred over open surgery in many cases due to its less invasive nature and reduced risk of complications.

The vascular surgeon is responsible for pre-operative planning, including imaging and device selection; performing the procedure, which includes arterial access, endograft placement, balloon occlusion (if necessary), angioplasty and/or stenting; post-operative monitoring and follow-up care.

IMPORTANT:34705 (for non-ruptured aneurysms), 34709 (for additional extension prosthesis placement), 34717 (add-on code for bifurcated endograft in common iliac artery with extensions into internal and external iliac arteries), 49000 (decompressive laparotomy for abdominal compartment syndrome).

In simple words: This code describes a minimally invasive surgery to repair a weakened or ruptured aorta (the main artery) and/or iliac arteries (major arteries leading to the legs). A Y-shaped tube-like device is inserted through a small incision to reinforce the weakened areas and restore normal blood flow.The procedure involves imaging guidance and may include additional steps to widen the arteries.

Endovascular repair of the infrarenal aorta and/or iliac artery(ies) involving the deployment of an aorto-bi-iliac endograft.This includes pre-procedure sizing and device selection, all nonselective catheterizations, associated radiological supervision and interpretation, all endograft extensions from the renal arteries to the iliac bifurcation, and angioplasty/stenting performed from the renal arteries to the iliac bifurcation.For ruptured aneurysms, temporary aortic and/or iliac balloon occlusion is included when performed.The procedure addresses conditions such as aneurysm, pseudoaneurysm, dissection, penetrating ulcer, or traumatic disruption.

Example 1: A 70-year-old male presents with a ruptured infrarenal abdominal aortic aneurysm.The surgeon performs an endovascular repair using an aorto-bi-iliac endograft, including balloon occlusion of the aorta and iliac arteries., A 65-year-old female with a dissecting infrarenal aortic aneurysm undergoes an endovascular repair with an aorto-bi-iliac endograft.Angioplasty of a stenotic iliac artery is also performed., An 80-year-old male with a chronic pseudoaneurysm of the common iliac artery requires an aorto-bi-iliac endograft placement.No balloon occlusion is necessary.

Pre-operative imaging (angiogram, CT scan), operative report detailing device selection, placement, and any additional procedures (angioplasty, stenting, balloon occlusion), post-operative angiogram to confirm graft placement and patency.

** Accurate coding requires meticulous documentation of the procedure performed, including the type of endograft used, the location of placement and termination of the endograft, and any additional procedures performed.Procedures outside the treatment zone should be coded separately.

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