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2025 CPT code 61623

Endovascular temporary balloon arterial occlusion of the head or neck (extracranial/intracranial), including selective catheterization, balloon positioning and inflation, neurological monitoring, and radiologic supervision and interpretation of angiography.

Refer to CPT guidelines for specific instructions regarding coding of temporary balloon occlusion procedures.

Modifiers may be applicable in certain circumstances, such as modifier 52 for reduced services or modifier 22 for increased procedural services.

Medical necessity for temporary balloon occlusion is established by the underlying condition requiring surgical intervention, such as an aneurysm, vascular injury, or other condition where controlled blood flow is essential.

The physician performs selective catheterization, positions and inflates the occlusion balloon, provides concomitant neurological monitoring, and supervises and interprets all angiography required for balloon occlusion and to exclude vascular injury post-occlusion.

IMPORTANT If selective catheterization and angiography of arteries other than the artery to be occluded are performed, use appropriate catheterization and radiologic supervision and interpretation codes. If complete diagnostic angiography of the artery to be occluded is performed immediately prior to temporary occlusion, use appropriate radiologic supervision and interpretation codes only.

In simple words: This procedure temporarily blocks blood flow in the head or neck arteries using a tiny balloon during another procedure, like fixing a weakened blood vessel.The doctor uses X-ray imaging and a special dye to see the artery and then inflates a small balloon to block it temporarily. This helps control bleeding while they fix the problem.

This procedure involves using a temporary balloon occlusion (TBO) to control blood flow in the head or neck arteries during another procedure (e.g., aneurysm repair).After prepping and anesthetizing the patient, a guide wire is placed at the artery defect, and an angiography catheter is advanced through the guide wire for angiography. The guide wire is reinserted, a TBO is advanced through it, and the balloon is expanded under fluoroscopic guidance. Contrast is injected to confirm blockage, and the patient is monitored for neurological changes. The balloon is deflated, and the procedure is repeated after 10 minutes.

Example 1: A patient with a complex intracranial aneurysm requires temporary occlusion of the parent artery during surgical clipping., A patient undergoing carotid endarterectomy requires temporary balloon occlusion to control blood flow during the procedure., A patient with a traumatic carotid artery injury requires temporary balloon occlusion to facilitate repair.

Documentation should include details of the primary procedure requiring temporary balloon occlusion, the specific artery occluded, the method of occlusion, neurological monitoring findings, angiography findings, and any complications.

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