How To Use CPT Code 34451

CPT 34451 describes a surgical procedure known as thrombectomy, which involves the removal of a blood clot in the vena cava, iliac, or femoropopliteal vein. This article will provide an overview of CPT code 34451, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 34451?

CPT 34451 is a code used to describe a surgical procedure called thrombectomy. This procedure involves the removal of a blood clot from the vena cava, iliac, or femoropopliteal vein. The provider makes an incision in the leg and abdomen to gain access to the affected vein, removes the clot, and closes the incision.

2. Official Description

The official description of CPT code 34451 is: ‘Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision.’

3. Procedure

1. During the thrombectomy procedure, the patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the abdomen and leg to gain access to the vena cava, iliac, or femoropopliteal vein.
3. The provider identifies the site of the clot and places clips on the vessel on either side of the clot.
4. An incision is made in the vessel to reach the clot.
5. The provider excises the clot and may introduce a balloon catheter at the site past the clot.
6. The balloon catheter is inflated and then pulled out to remove all the clots.
7. The provider repairs the vein and checks for normal blood flow pattern through the repaired vessel, such as by using a Doppler probe.
8. The incision is closed with sutures in layers.

4. Qualifying circumstances

CPT code 34451 is used when a patient requires a thrombectomy procedure to remove a blood clot in the vena cava, iliac, or femoropopliteal vein. The procedure is typically performed when the clot obstructs blood flow and poses a risk to the patient’s health. It is important to note that this procedure requires a skilled provider who is experienced in performing thrombectomies.

5. When to use CPT code 34451

CPT code 34451 should be used when a provider performs a thrombectomy procedure to remove a blood clot in the vena cava, iliac, or femoropopliteal vein. It is important to ensure that the procedure is performed through an abdominal and leg incision. If the procedure is performed through a different approach or involves a different vein, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT code 34451, the provider must document the following information:

• Patient’s diagnosis indicating the need for a thrombectomy procedure
• Details of the procedure, including the specific veins involved and the approach used (abdominal and leg incision)
• Date of the procedure
• Any additional procedures or interventions performed during the same session
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 34451, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure must involve a thrombectomy in the vena cava, iliac, or femoropopliteal vein, performed through an abdominal and leg incision. It is also important to follow any additional guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 34451 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates since its addition. However, it is important to stay updated with any changes or revisions to coding guidelines or payer requirements.

9. Examples

1. A patient undergoes a thrombectomy procedure to remove a blood clot in the vena cava through an abdominal and leg incision.
2. A provider performs a thrombectomy to remove a clot in the iliac vein using an abdominal and leg incision.
3. A patient requires a femoropopliteal vein thrombectomy, which is performed through an abdominal and leg incision.
4. A provider performs a thrombectomy in the vena cava, iliac, and femoropopliteal vein using an abdominal and leg incision.
5. A patient undergoes a thrombectomy procedure to remove a clot in the vena cava and iliac vein through an abdominal and leg incision.
6. A provider performs a thrombectomy in the femoropopliteal vein using an abdominal and leg incision.
7. A patient requires a thrombectomy procedure in the vena cava and iliac vein, which is performed through an abdominal and leg incision.
8. A provider performs a thrombectomy in the vena cava and femoropopliteal vein using an abdominal and leg incision.