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2025 CPT code 34847

Endovascular repair of the visceral and infrarenal abdominal aorta using a fenestrated endograft, including three visceral artery endoprostheses.

Follow current CPT coding guidelines for vascular procedures.Accurate documentation is critical for appropriate code selection and reimbursement.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., multiple procedures, assistant surgeon). Consult the CPT manual for appropriate modifier use.

Medical necessity is established by the presence of an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption of the visceral or infrarenal aorta threatening organ perfusion.Severe symptoms or imminent rupture may necessitate urgent intervention.

The surgeon performs the endovascular procedure, including access, guidewire placement, endograft deployment, and placement of visceral artery endoprostheses.Radiological supervision and interpretation are inherent to the procedure. Anesthesiologist may be involved.

IMPORTANT:Codes 34841-34844 describe similar repairs but with fewer visceral artery endoprostheses. Codes 34845-34848 include infrarenal aortic repair extending into the common iliac arteries.

In simple words: This code describes a minimally invasive procedure to repair a weakened or damaged area in the main blood vessel supplying the abdomen (aorta).A special type of stent-graft with openings (fenestrations) is placed, along with three additional smaller stents to keep blood flowing properly to vital organs.

Endovascular repair of the visceral aorta and infrarenal abdominal aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and a concomitant unibody or modular infrarenal aortic endograft.The procedure includes all associated radiological supervision and interpretation, including target zone angioplasty when performed, and placement of three visceral artery endoprostheses (superior mesenteric, celiac, and/or renal arteries).

Example 1: A 70-year-old male presents with a large abdominal aortic aneurysm involving the visceral aorta.A fenestrated endograft is placed, along with three visceral artery endoprostheses to preserve blood flow to the celiac, superior mesenteric, and right renal arteries., A 65-year-old female with a history of aortic dissection requires endovascular repair of the visceral and infrarenal aorta.A fenestrated endograft is deployed, with endoprostheses placed in the celiac, superior mesenteric, and left renal arteries., An 80-year-old male with a traumatic aortic rupture undergoes emergent endovascular repair. A fenestrated endograft is used, along with three visceral artery endoprostheses to maintain perfusion to the visceral organs.

Pre-operative imaging (CTA or MRA), operative report detailing the type of endograft, number and location of fenestrations and endoprostheses, intra-operative fluoroscopy images, post-operative angiography to confirm patency.

** This procedure often requires significant planning and pre-operative imaging to ensure accurate endograft sizing and fenestration placement.The number of visceral artery endoprostheses will depend on the individual patient anatomy and the extent of vascular involvement.

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