2025 CPT code 34401
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), bilateral procedures (50), or assistant surgeon (80).Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity for 34401 is established when less invasive methods are contraindicated or have failed, and the patient's condition requires direct removal of the thrombus to prevent significant morbidity or mortality. This could include extensive or complex DVT, phlegmasia cerulea dolens, or IVC filter-related thrombosis.
The surgeon prepares the patient, makes the abdominal incision, locates the clot, and removes it either directly or with a catheter.They then ensure proper blood flow and close the incision.
In simple words: This procedure removes a blood clot from a large vein in the abdomen, either the vena cava or the iliac vein.The surgeon makes an incision in the abdomen to access the vein and remove the clot, sometimes using a thin tube called a catheter. The procedure helps restore normal blood flow.
This procedure involves the removal of a blood clot (thrombus) from the vena cava or iliac vein through an abdominal incision. The surgeon may directly excise the clot or use a catheter, potentially with a balloon tip, to extract it.The procedure includes establishing both inflow and outflow, and any necessary intraoperative arteriogram performed by the surgeon.It also includes sympathectomy if performed.
Example 1: A patient presents with deep vein thrombosis (DVT) in the iliac vein, causing severe swelling and pain.Conservative treatment is unsuccessful, and the decision is made to perform a thrombectomy via abdominal incision (34401) to directly remove the clot., A patient with an IVC filter develops filter-related thrombosis in the vena cava. Due to the filter's presence and the extent of the clot, open surgical thrombectomy (34401) is chosen to remove the clot and potentially the filter., A patient experiences extensive DVT involving both the vena cava and iliac vein following abdominal surgery.To prevent further complications like pulmonary embolism, the surgeon performs an abdominal thrombectomy (34401) to clear the clot.
Documentation should include the diagnosis (e.g., DVT), location and extent of the thrombus, method of removal (direct or catheter), intraoperative findings, and any complications.Preoperative imaging and post-operative assessment of blood flow should also be documented. Medical necessity for the open procedure should be clearly justified.
- Revenue Code: P2F
- Specialties:Vascular Surgery, Cardiothoracic Surgery, General Surgery.
- Place of Service:Inpatient Hospital