How To Use CPT Code 0553T

CPT 0553T describes the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant, which includes all necessary radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0553T?

CPT 0553T can be used to describe the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant. This procedure involves creating a connection between the iliac vein and iliac artery using a specially designed stentlike coupler or clip device delivered via a catheter inserted through the skin under imaging guidance. The code includes all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention.

2. Official Description

The official description of CPT code 0553T is: ‘Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention.’

3. Procedure

1. The provider begins by making a small incision in the skin over the iliac vein and artery, typically just above the femoral head.
2. Under fluoroscopic guidance, a coiled guidewire is inserted into the iliac artery to outline its course.
3. A curved needle is then introduced into the iliac vein and subsequently into the iliac artery, using the coiled guidewire in the iliac artery as a target.
4. Still under fluoroscopic guidance, a straight guidewire is passed through the lumen of the needle to confirm access from the vein to the artery.
5. A delivery catheter is advanced over the straight guidewire, and both guidewires are removed.
6. Through the catheter, a nitinol stentlike anastomotic clip, such as a ROX™ arteriovenous coupler, is passed, creating an anastomosis between the iliac vein and artery.
7. The provider withdraws the catheter, applies pressure over the vessels to control bleeding, and closes the incision in layers.

4. Qualifying circumstances

Patients who may qualify for CPT 0553T are those who require a percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant. This procedure is typically performed on patients with specific medical conditions or situations that necessitate this intervention. It is important to note that CPT 0553T should not be reported in conjunction with certain other codes, such as 36005, 36011, 36012, 36140, 36245, 36246, 37220, 37221, 37224, 37226, 37238, 37248, 75710, or 75820.

5. When to use CPT code 0553T

CPT code 0553T should be used when a provider performs the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant. It is important to ensure that this code is not reported in conjunction with the excluded codes mentioned earlier.

6. Documentation requirements

To support a claim for CPT 0553T, the provider must document the following information:

• Patient’s medical condition necessitating the procedure
• Details of the procedure performed, including the specific implant used
• Date and duration of the procedure
• Imaging guidance and roadmapping utilized during the intervention
• Radiological supervision and interpretation provided
• Any complications or additional procedures performed
• Provider’s signature

7. Billing guidelines

When billing for CPT 0553T, it is important to ensure that the procedure meets the criteria outlined in the code description. Additionally, it should not be reported with the excluded codes mentioned earlier. It is advisable to seek guidance from the payer regarding coverage and reimbursement for this procedure. Proper documentation and coding are essential for accurate billing and reimbursement.

8. Historical information

CPT 0553T was added to the Current Procedural Terminology system as a Category III code. Category III codes are temporary codes used to collect information about the use and efficacy of investigational technologies and procedures. As of now, there have been no updates to this code since its addition.

9. Examples

1. A patient with a specific medical condition requires a percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant to improve blood flow.
2. A provider performs the procedure on a patient who has experienced trauma resulting in an arteriovenous fistula between the iliac vein and artery.
3. A patient with a congenital arteriovenous anastomosis undergoes the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant to manage their condition.
4. A provider performs the procedure on a patient with a medical condition that necessitates the creation of an arteriovenous connection between the iliac vein and artery.
5. A patient with compromised blood flow in the iliac vessels undergoes the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant to improve circulation.
6. A provider performs the procedure on a patient who requires a minimally invasive method of improving blood flow between the iliac vein and artery.
7. A patient with a specific medical condition that affects the iliac vessels undergoes the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant to alleviate symptoms.
8. A provider performs the procedure on a patient with a medical condition that requires the creation of an arteriovenous connection in the iliac region.
9. A patient with a congenital arteriovenous fistula between the iliac vein and artery undergoes the percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant to manage their condition.
10. A provider performs the procedure on a patient with compromised blood flow in the iliac vessels to restore proper circulation.