How To Use CPT Code 0505T

CPT 0505T describes the endovenous femoral-popliteal arterial revascularization procedure, which involves the restoration of blood flow to the femoral-popliteal arteries using a stent graft and closure by any method. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0505T.

1. What is CPT Code 0505T?

CPT 0505T is a code that represents the endovenous femoral-popliteal arterial revascularization procedure. It involves the placement of an intravascular stent graft to restore blood flow in the femoral-popliteal arteries. The procedure also includes closure by any method, percutaneous or open vascular access, and the use of ultrasound guidance for vascular access if necessary. All catheterization(s), intraprocedural roadmapping, and imaging guidance are also included in this intervention.

2. Official Description

The official description of CPT code 0505T is: ‘Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed, with crossing of the occlusive lesion in an extraluminal fashion.’

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the need for endovenous femoral-popliteal arterial revascularization.
2. A small incision is made through the skin or an open incision over a vein in the groin, typically on the opposite side from the occlusion.
3. Using ultrasound guidance, the provider inserts a guidewire and advances it to the femoral-popliteal arteries.
4. A catheter is then advanced over the guidewire, and a contrast material may be injected to visualize the arteries and map the blood circulation.
5. If necessary, the provider creates a subintimal channel in the vessel wall to bypass the occlusion using a specially designed catheter or guidewire.
6. Once the occlusion is crossed, the provider inserts a stent graft through the catheter or over the guidewire to keep the vessel open and maintain blood flow.
7. All incisions are repaired, bleeding is checked, and the procedure is concluded.

4. Qualifying circumstances

CPT code 0505T is used for patients with peripheral arterial disease or severe ischemia or claudication in the lower extremities. The procedure is performed by a provider who is experienced in endovenous femoral-popliteal arterial revascularization. It is important to note that CPT code 0505T should not be reported in conjunction with other specific codes within the femoral-popliteal segment or for ultrasound guidance for vascular access.

5. When to use CPT code 0505T

CPT code 0505T should be used when performing the endovenous femoral-popliteal arterial revascularization procedure. It is appropriate for patients with peripheral arterial disease or severe ischemia or claudication in the lower extremities. However, it should not be reported with other specific codes within the femoral-popliteal segment or for ultrasound guidance for vascular access.

6. Documentation requirements

To support a claim for CPT code 0505T, the provider must document the following information:

• Patient’s diagnosis and the need for endovenous femoral-popliteal arterial revascularization
• Specific details of the procedure, including the use of stent graft(s), closure method, and any percutaneous or open vascular access
• Date of the procedure and duration
• Imaging guidance used, such as ultrasound, fluoroscopy, or other forms of imaging
• Any associated radiological supervision and interpretation
• Details of the occlusive lesion and the extraluminal crossing
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0505T, ensure that the procedure meets all the necessary criteria, including the placement of intravascular stent graft(s), closure by any method, and the use of ultrasound guidance for vascular access if performed. It is important to note that CPT code 0505T should not be reported with other specific codes within the femoral-popliteal segment or for ultrasound guidance for vascular access. Follow the appropriate coding guidelines and modifiers when submitting the claim.

8. Historical information

CPT code 0505T was added to the Current Procedural Terminology system on April 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. A patient with peripheral arterial disease undergoes endovenous femoral-popliteal arterial revascularization using a stent graft to restore blood flow.
2. A provider performs the procedure on a patient with severe ischemia in the lower extremities, using ultrasound guidance for vascular access and mapping.
3. An individual with claudication in the femoral-popliteal arteries undergoes endovenous femoral-popliteal arterial revascularization to alleviate the symptoms.
4. A patient with peripheral arterial disease in the lower extremities undergoes the procedure to improve blood circulation and prevent further complications.
5. A provider performs endovenous femoral-popliteal arterial revascularization on a patient with severe ischemia in the femoral-popliteal arteries, using a stent graft and closure by a percutaneous method.
6. An individual with claudication in the lower extremities undergoes the procedure to alleviate pain and improve mobility.
7. A patient with peripheral arterial disease undergoes endovenous femoral-popliteal arterial revascularization using a stent graft and closure by an open vascular access method.
8. A provider performs the procedure on a patient with severe ischemia in the femoral-popliteal arteries, using ultrasound guidance for vascular access and intraprocedural roadmapping.
9. An individual with claudication in the lower extremities undergoes endovenous femoral-popliteal arterial revascularization to improve blood flow and alleviate symptoms.
10. A patient with peripheral arterial disease in the femoral-popliteal arteries undergoes the procedure to restore blood flow and prevent further complications.