2025 CPT code 75958
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Angiography Radiology Feed
Placement of proximal extension prosthesis for endovascular repair of the descending thoracic aorta; radiological supervision and interpretation.
Modifiers 26 (professional component only), TC (technical component only), and 52 (reduced services) may be applicable depending on the services performed and payer requirements. Consult payer specific guidelines for additional modifier rules.
Medical necessity for this procedure is established by the presence of a clinically significant condition such as an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption of the descending thoracic aorta, requiring endovascular repair.The need for a proximal extension must be clearly documented by imaging demonstrating a persistent leak or incomplete exclusion of the pathology.
The interventional radiologist or cardiologist is responsible for the procedural aspects, including image guidance and placement of the endovascular extension. The radiologist is also responsible for interpreting the angiographic images throughout the procedure to ensure proper device placement and the absence of complications.
- Radiology
- Radiology Procedures > Diagnostic Radiology (Diagnostic Imaging) Procedures > Angiography
In simple words: This code covers the doctor's work in using imaging (like X-rays) to watch and guide the placement of a stent-like device to fix a problem in the main artery leading to the lower body.This is often done after a prior repair of the artery.The imaging helps the doctor see exactly where to place the device and check if it is working correctly.
This CPT code 75958 reports the radiological supervision and interpretation during the placement of a proximal extension prosthesis for the endovascular repair of the descending thoracic aorta. This procedure is indicated for various aortic pathologies such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions.The procedure involves fluoroscopic guidance for the placement of the prosthesis, typically a stent, at the site of the aortic abnormality.Post-placement angiography is included to confirm placement and identify any complications.This code is reported for each proximal extension placed.
Example 1: A patient presents with a post-operative pseudoaneurysm of the descending thoracic aorta following a previous aortic stent graft placement. This code would be used to describe the radiological supervision and interpretation during the placement of a proximal extension to seal the leak., A patient with a type B aortic dissection is undergoing endovascular repair. Following the placement of the main stent graft, the physician finds that an additional extension is necessary to adequately cover the dissection flap. This code would be used to report the radiological services for the placement of the proximal extension., A patient with a descending thoracic aortic aneurysm receives an endovascular stent graft.Post-procedure imaging reveals an endoleak. A proximal extension is deployed to address the endoleak. This code would accurately represent the radiological supervision and interpretation during the extension deployment.
Pre-procedure documentation should include the patient's medical history, physical examination findings, relevant imaging studies (e.g., CT scan, MRI, aortogram), and the indication for the procedure. Intra-procedural documentation should include details of the fluoroscopic guidance, the type and size of the stent graft extension, the location of placement, angiographic images before and after placement, and any complications encountered. Post-procedure documentation should include a final angiogram, a summary of the procedure, and a plan for follow-up care.All documentation must support medical necessity.
** This code should only be reported for the placement of proximal extensions.Distal extensions are reported with code 75959.Always ensure that all components of the endovascular repair are properly documented and coded.
- Revenue Code: I4B (Imaging/Procedure - Other)
- RVU: RVUs will vary depending on geographic location and other factors. Consult your local Medicare fee schedule or other payer's relative value units.
- Global Days: Global period information not specified in available data.Refer to payer specific guidelines for global period details.
- Payment Status: Active
- Modifier TC rule: Modifier TC may apply if only the technical component of the service is reported. This is usually billed by the facility.However, payer policies may vary.
- Fee Schedule: Historical fee schedule data is not included. Check your local Medicare fee schedule or other payer's fee schedules for relevant historical data.
- Specialties:Interventional Cardiology, Interventional Radiology, Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center