How To Use CPT Code 34717

CPT 34717 describes the endovascular repair of the iliac artery during the placement of an aorto-iliac artery 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 34717?

CPT 34717 can be used to describe the endovascular repair of the iliac artery during the placement of an aorto-iliac artery endograft. This procedure involves deploying an iliac branched endograft to repair a rupture or other defect in the iliac artery and its major branches on one side of the body. It includes pre-procedure sizing and device selection, selective catheterization of the ipsilateral iliac artery, radiological supervision and interpretation, and endograft extension proximally to the aortic bifurcation and distally in the internal iliac, external iliac, and common femoral artery(ies). Treatment zone angioplasty/stenting may also be performed if necessary.

2. Official Description

The official description of CPT code 34717 is: ‘Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally in the internal iliac, external iliac, and common femoral artery(ies), and treatment zone angioplasty/stenting, when performed, for rupture or other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, penetrating ulcer, traumatic disruption), unilateral (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider begins by prepping and anesthetizing the patient for aorto-iliac artery endograft placement.
2. The provider identifies the femoral artery on the side of the body where the procedure will be performed.
3. A guidewire is introduced into the femoral artery and advanced to the diseased portion of the common iliac artery.
4. A sheath containing a bifurcated tube device (endograft) is then introduced over the guidewire and positioned with the main stem in the iliac artery and one branch in the external and one in the internal iliac artery.
5. If necessary, the provider may add extensions to reach past any defects in the internal and external iliac arteries and to the femoral artery.
6. The provider may also perform angioplasty or insert a stent to address any additional issues in the artery.
7. Intraoperative angiography is performed to ensure proper blood flow restoration.
8. The provider completes the placement of the aorto-iliac artery endograft and removes all instruments, controls bleeding, and closes the wound.

4. Qualifying circumstances

CPT 34717 is used for patients who require endovascular repair of the iliac artery during the placement of an aorto-iliac artery endograft. This procedure is typically performed for conditions such as aneurysms, pseudoaneurysms, dissections, arteriovenous malformations, penetrating ulcers, and traumatic disruptions. It is important to note that CPT 34717 is a unilateral code and should be reported separately in addition to the code for the primary procedure.

5. When to use CPT code 34717

CPT code 34717 should be used when the provider performs endovascular repair of the iliac artery during the placement of an aorto-iliac artery endograft. It is important to report this code in conjunction with the appropriate primary code for the procedure. It should not be reported with code 34709 on the same side.

6. Documentation requirements

To support a claim for CPT 34717, the provider must document the following information:

• Indication for the endovascular repair of the iliac artery
• Pre-procedure sizing and device selection
• Date and duration of the procedure
• Details of the selective iliac artery catheterization(s)
• Details of the endograft deployment and extension(s)
• Any angioplasty or stenting performed
• Radiological supervision and interpretation
• Unilateral nature of the procedure

7. Billing guidelines

When billing for CPT 34717, ensure that the procedure meets the criteria for endovascular repair of the iliac artery during the placement of an aorto-iliac artery endograft. It is important to report this code in conjunction with the appropriate primary code. Modifier 50 should not be used with CPT 34717. Review the specific guidelines for reporting this code to ensure accurate billing.

8. Historical information

CPT 34717 was added to the Current Procedural Terminology system on January 1, 2020. It has not undergone any updates since its addition. Additionally, it is important to note that CPT 34717 is listed as an Inpatient Only (IPO) procedure for Medicare.

9. Examples

1. A patient undergoes endovascular repair of the iliac artery during the placement of an aorto-iliac artery endograft to treat a ruptured aneurysm.