How To Use CPT Code 33886

CPT 33886 describes the placement of a distal extension prosthesis in the descending thoracic aorta after endovascular repair. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33886?

CPT 33886 is used to describe the placement of a distal extension prosthesis in the descending thoracic aorta after endovascular repair. This procedure is commonly performed to repair an endoleak in the descending thoracic aorta that had been previously grafted due to an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption. The prosthesis is placed using a guidewire and fluoroscopy to guide its positioning and ensure proper component placement.

2. Official Description

The official description of CPT code 33886 is: ‘Placement of distal extension prosthesis(s) delayed after endovascular repair of descending thoracic aorta.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider performs arteriography to visualize the inside of blood vessels and confirm the patient’s anatomy.
3. The provider prepares the first distal extension component and loads it on the guidewire.
4. Under fluoroscopy, the provider guides the component through the femoral artery, into the iliac artery, and up the descending thoracic aorta.
5. The provider positions the device so it partially overlaps with the previously placed components and deploys it.
6. A balloon catheter is advanced from the femoral access and inflated to seat the component and stop the leak.
7. The provider confirms proper placement with imaging.
8. The steps are repeated as needed to seat additional components.
9. The catheters and wires are removed, and the site is closed.

4. Qualifying circumstances

CPT 33886 is performed in cases where there is a need to repair an endoleak in the descending thoracic aorta that had been previously grafted. The procedure is indicated for patients with an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption in the descending thoracic aorta. The prosthesis is placed using a guidewire and fluoroscopy to guide its positioning and ensure proper component placement.

5. When to use CPT code 33886

CPT code 33886 should be used when a distal extension prosthesis is placed in the descending thoracic aorta after endovascular repair. It is important to note that CPT code 33886 should not be reported in conjunction with CPT codes 33880 and 33881. Additionally, CPT code 33886 should only be reported once, regardless of the number of modules deployed.

6. Documentation requirements

To support a claim for CPT code 33886, the following documentation is required:

• Patient’s diagnosis and indication for the procedure
• Details of the procedure, including the use of a guidewire and fluoroscopy
• Confirmation of proper component placement and seating
• Imaging documentation to support the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 33886, it is important to ensure that the procedure meets the qualifying circumstances and documentation requirements. CPT code 33886 should not be reported in conjunction with CPT codes 33880 and 33881. Additionally, radiological supervision and interpretation should be reported using CPT code 75959 in conjunction with CPT code 33886. It is important to review the extensive list of edits for this code to avoid reporting additional codes for work that is included in the procedure.

8. Historical information

CPT code 33886 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes endovascular repair of a descending thoracic aorta aneurysm. The provider places a distal extension prosthesis to repair an endoleak, using a guidewire and fluoroscopy to guide the positioning and seating of the component.
2. A patient with a penetrating ulcer in the descending thoracic aorta undergoes endovascular repair. The provider places a distal extension prosthesis to repair the endoleak, ensuring proper component placement using a guidewire and fluoroscopy.
3. Following endovascular repair of a traumatic disruption in the descending thoracic aorta, the provider places a distal extension prosthesis to repair the endoleak. The procedure involves the use of a guidewire and fluoroscopy to guide the positioning and seating of the component.
4. A patient with an intramural hematoma in the descending thoracic aorta undergoes endovascular repair. The provider places a distal extension prosthesis to repair the endoleak, ensuring proper component placement using a guidewire and fluoroscopy.
5. After endovascular repair of a pseudoaneurysm in the descending thoracic aorta, the provider places a distal extension prosthesis to repair the endoleak. The procedure involves the use of a guidewire and fluoroscopy to guide the positioning and seating of the component.