How To Use CPT Code 34706

CPT 34706 describes the endovascular repair of the infrarenal aorta and/or iliac artery(ies) using an aorto-bi-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 34706?

CPT 34706 is used to describe the endovascular repair of the infrarenal aorta and/or iliac artery(ies) using an aorto-bi-iliac endograft. This procedure involves the deployment of the endograft, pre-procedure sizing and device selection, nonselective catheterization(s), radiological supervision and interpretation, and any angioplasty/stenting performed from the renal arteries to the iliac bifurcation. It is typically performed to repair a ruptured infrarenal aorta or iliac artery due to conditions such as an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, or traumatic disruption.

2. Official Description

The official description of CPT code 34706 is: ‘Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-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 and dissecting down through the tissue to expose the infrarenal aorta and iliac arteries.
2. If necessary, the provider may use a balloon inserted through a catheter to occlude (close off) the aortic and/or iliac arteries beyond the ruptured area.
3. Angioplasty or stenting may be performed to open up or widen the lumen of the aorta or iliac arteries.
4. The provider then deploys an aorto-bi-iliac endograft, which is a Y-shaped tube graft, through a catheter.
5. The single end of the endograft is inserted into the aorta, and each arm of the Y is inserted down an iliac artery, extending into healthy areas on both sides of the defect.
6. If the endograft is not long enough, extensions may be placed up the aorta to the level of the renal arteries and down to the iliac bifurcation.
7. Once the endograft is in place, it reinforces the artery walls and restores blood flow.
8. The provider withdraws the catheter, checks for bleeding, and closes all incisions.