2025 CPT code 34844
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Endovascular repair of the visceral aorta using a fenestrated endograft and four or more visceral artery endoprostheses.
Modifiers may be applicable based on the circumstances of the procedure. Consult the CPT manual for appropriate modifier usage.
Medical necessity is established by the presence of a visceral aortic aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption that poses a significant risk of rupture or other life-threatening complications. The fenestrated endograft is deemed medically necessary to preserve blood flow to vital organs supplied by the visceral arteries while simultaneously treating the aortic pathology.
The clinical responsibility includes pre-operative planning, patient positioning, surgical access, guidewire placement and manipulation, endoprosthesis deployment and fixation, placement of visceral artery endoprostheses, intraoperative angiography, and post-operative evaluation of the repair.
In simple words: This code describes a minimally invasive procedure to repair a weakened or damaged area in the upper abdominal aorta (the main artery supplying blood to the abdomen). A special type of stent-graft (a mesh tube with openings) is inserted through a small incision in the groin and positioned in the aorta.Additionally, smaller stents are placed into branches of the aorta to ensure proper blood flow.This is done using X-ray guidance.
Endovascular repair of the visceral aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) involving deployment of a fenestrated visceral aortic endograft.The procedure includes placement of four or more visceral artery endoprostheses (superior mesenteric, celiac, and/or renal arteries) and all associated radiological supervision and interpretation, including target zone angioplasty, when performed.Introduction of guide wires and catheters in the aorta and visceral and/or renal arteries is included. Catheterization of the hypogastric artery(s) and/or arterial families outside the treatment zone of the graft may be separately reported. Balloon angioplasty within the target treatment zone of the endograft, either before or after endograft deployment, is not separately reportable. Fluoroscopic guidance and radiological supervision and interpretation are included.
Example 1: A 70-year-old male presents with a large visceral aortic aneurysm involving the celiac, superior mesenteric, and bilateral renal arteries.A fenestrated endograft is deployed, along with four endoprostheses for the visceral arteries., A 65-year-old female with a complex aortic dissection requiring treatment of the visceral aorta and four visceral arteries undergoes fenestrated endograft placement with four additional visceral artery endoprostheses., An 80-year-old male with a traumatic aortic injury involving the visceral aorta and multiple visceral arteries requires emergent fenestrated endovascular repair with four endoprostheses to restore blood flow.
Pre-operative imaging (CT, CTA, MRI) showing the aortic anatomy and the extent of the aneurysm or other pathology.Detailed operative report including the type and size of the endograft and endoprostheses used, number of visceral arteries treated, and intra-operative angiographic images documenting placement and patency. Post-operative imaging to confirm the success of the repair.
** This code is highly complex and requires detailed documentation to support medical necessity and proper reimbursement.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital