How To Use CPT Code 34704

CPT 34704 describes the endovascular repair of the infrarenal aorta and/or iliac artery using an aorto-uni-iliac endograft. 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 34704?

CPT 34704 is used to describe the endovascular repair of the infrarenal aorta and/or iliac artery using an aorto-uni-iliac endograft. This procedure involves the deployment of the endograft, pre-procedure sizing and device selection, nonselective catheterization, radiological supervision and interpretation, and any angioplasty or stenting performed from the renal arteries to the iliac bifurcation. It is typically performed for conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, traumatic disruptions, or other reasons that require repair of the infrarenal aorta or iliac artery.

2. Official Description

The official description of CPT code 34704 is: ‘Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)’

3. Procedure

1. The provider begins by making an incision in the groin area and dissecting down to expose the infrarenal aorta and/or iliac artery.
2. If necessary, the provider may use a balloon inserted through a catheter to occlude the aortic and/or iliac arteries beyond the ruptured area.
3. The provider may perform angioplasty or place a stent to open up or widen the lumen of the aorta or iliac arteries.
4. Under imaging guidance, the provider threads a catheter to the site of the rupture and guides a tube endograft through the catheter.
5. The endograft is positioned across the tear in the wall of the aorta and/or iliac artery, extending into healthy areas on both sides of the rupture.
6. If the endograft is not long enough, the provider may add extensions up the aorta to the renal arteries and down to the iliac bifurcation.
7. The endograft reinforces the artery walls and restores blood flow.
8. The provider withdraws the catheter, checks for bleeding, and closes all incisions.