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2025 CPT code 34848

Endovascular repair of the visceral and infrarenal abdominal aorta using a fenestrated visceral aortic endograft and a concomitant unibody or modular infrarenal aortic endograft, including four or more visceral artery endoprostheses.

Follow current CPT coding guidelines and ensure proper documentation to support the medical necessity and the extent of the procedure performed.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for appropriate modifier usage.

Medical necessity is established when the patient presents with a life-threatening or severely compromising condition such as an abdominal aortic aneurysm, dissection, or other vascular pathology that poses a significant risk of rupture, organ ischemia, or death. The endovascular approach must be deemed clinically appropriate, considering the patient's overall health status and the anatomical features of the lesion.

The physician is responsible for patient positioning, preparation, and administration of anesthesia.They perform the surgical incision, access the femoral artery, guide the endovascular device and guidewire into the aorta, identify the aneurysm or vascular problem, and guide the wire to a point above the renal arteries.They then access the opposite femoral artery, introduce the fenestrated endoprosthesis, and fixate it.Four or more additional visceral artery prostheses are placed through the fenestrations and fixed.Aortography may be performed.The physician inspects the blood vessels for accurate fixation, absence of blood flow issues, and clots.Finally, they remove the instruments and close the incision.

IMPORTANT:Do not report 34845, 34846, 34847, 34848 in conjunction with 34701, 34702, 34703, 34704, 34705, 34706, 34841, 34842, 34843, 34844, 35081, 35102. Do not report 34845, 34846, 34847, 34848 in conjunction with 34839, when planning services are performed on the day before or the day of the fenestrated endovascular repair procedure. Do not report 34841-34848 in conjunction with 37236, 37237 for bare metal or covered stents placed into the visceral branches within the endoprosthesis target zone. For placement of distal extension prosthesis[es] terminating in the internal iliac, external iliac, or common femoral artery[ies], see 34709, 34710, 34711, 34718. Use 34845, 34846, 34847, 34848 in conjunction with 37220, 37221, 37222, 37223, only when 37220, 37221, 37222, 37223 are performed outside the target treatment zone of the endoprosthesis.

In simple words: This code describes a minimally invasive procedure to repair a weakened or damaged area in the upper and lower abdominal aorta (the main artery supplying the body).A special graft with openings (fenestrations) is placed inside the artery to reinforce the weak area, and additional smaller grafts are placed in branches of the aorta to maintain blood flow to vital organs.Imaging guidance is used throughout the procedure.

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 concomitant unibody or modular infrarenal aortic endograft. This includes all associated radiological supervision and interpretation, including target zone angioplasty, when performed; and includes four or more visceral artery endoprostheses (superior mesenteric, celiac, and/or renal artery[s]).

Example 1: A 70-year-old male presents with an abdominal aortic aneurysm involving the visceral aorta and extending infrarenally.The physician performs an endovascular repair using a fenestrated endograft with four visceral artery endoprostheses., A 65-year-old female with a history of aortic dissection requires repair of the visceral and infrarenal aorta.A fenestrated endograft with five visceral artery endoprostheses is utilized., An 80-year-old male presents with a traumatic disruption of the abdominal aorta. The physician performs an endovascular repair with a fenestrated endograft and four visceral artery endoprostheses.

Detailed imaging studies (CT, CTA, or MRI) demonstrating the aneurysm or vascular pathology, operative report documenting the procedure, including the type and number of endografts used and the visceral arteries treated, and postoperative imaging to confirm the placement and patency of the endografts.

** This code encompasses a complex endovascular procedure requiring significant expertise and advanced imaging capabilities.Accurate coding requires meticulous documentation to reflect the precise nature and extent of the repair.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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