How To Use CPT Code 34708

CPT 34708 describes the endovascular repair of the iliac artery using an ilio-iliac tube 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 34708?

CPT 34708 is used to describe the endovascular repair of the iliac artery by deploying an ilio-iliac tube endograft. This procedure involves the placement of a prosthetic device to repair a ruptured iliac artery on one side of the body. The code includes pre-procedure sizing and device selection, nonselective catheterization, radiological supervision and interpretation, and any endograft extensions performed up to the aortic bifurcation and down to the iliac bifurcation. It also covers angioplasty and stenting, if necessary.

2. Official Description

The official description of CPT code 34708 is: ‘Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption)’

3. Procedure

1. The provider begins by making an incision in the groin and exposing the aorta and iliac arteries.
2. If necessary, the provider may temporarily occlude the iliac artery using a balloon inserted through a catheter.
3. Angioplasty or stenting may be performed to open up or widen the lumen of the iliac artery.
4. Under imaging guidance, the provider inserts a catheter into the iliac artery.
5. The ilio-iliac tube endograft is then guided through the catheter and positioned across the ruptured area and beyond into healthy areas on both sides of the defect.
6. If needed, extensions may be placed up to the aortic bifurcation and down to the iliac bifurcation.
7. The endograft reinforces the artery walls and restores blood flow.
8. The catheter is withdrawn, and all incisions are closed.

4. Qualifying circumstances

CPT 34708 is used for the endovascular repair of the iliac artery in cases of rupture, such as aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, or traumatic disruption. The procedure is performed unilaterally and may involve temporary aortic and/or iliac balloon occlusion. It is important to note that this code specifically applies to the deployment of an ilio-iliac tube endograft and not an iliac branched endograft.

5. When to use CPT code 34708

CPT code 34708 should be used when the provider performs the endovascular repair of the iliac artery using an ilio-iliac tube endograft. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including pre-procedure sizing and device selection, nonselective catheterization, and any necessary angioplasty or stenting. If the procedure involves the use of an iliac branched endograft, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 34708, the provider must document the following information:

• Patient’s diagnosis and indication for the endovascular repair
• Details of the pre-procedure sizing and device selection
• Date of the procedure and start and end times
• Specific procedures performed, such as nonselective catheterization, angioplasty, and stenting
• Extent of any endograft extensions performed
• Radiological supervision and interpretation
• Any temporary balloon occlusion performed
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 34708, it is important to ensure that the procedure meets all the criteria outlined in the code description. The provider should use the appropriate modifiers, if necessary, to indicate any additional procedures or complications. It is also important to follow any specific billing guidelines provided by the payer or Medicare. CPT code 34708 should not be reported if other related codes, such as CPT codes 34717 or 34718, have already been performed in the previous seven days.

8. Historical information

CPT code 34708 was added to the Current Procedural Terminology system on January 1, 2018. It was also added to the Inpatient Only (IPO) list for Medicare in 2018.

9. Examples

1. A patient presents with a ruptured iliac artery due to an aneurysm. The provider performs endovascular repair using an ilio-iliac tube endograft, including pre-procedure sizing, nonselective catheterization, angioplasty, and stenting.