How To Use CPT Code 34831

CPT 34831 describes the open repair of an infrarenal aortic aneurysm or dissection, along with the repair of associated arterial trauma, following an unsuccessful endovascular repair. 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 34831?

CPT 34831 is used to describe the open repair of an infrarenal aortic aneurysm or dissection, as well as the repair of associated arterial trauma, when an endovascular repair has been unsuccessful. This procedure involves making an incision in the abdomen or retroperitoneum to access the infrarenal aorta. The provider then repairs the aneurysm or dissection using an aorto-bi-iliac prosthesis, and also addresses any trauma resulting from the unsuccessful endovascular repair.

2. Official Description

The official description of CPT code 34831 is: ‘Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis.’

3. Procedure

1. After an unsuccessful endovascular repair, the provider makes an incision in the abdomen or retroperitoneum.
2. The provider dissects the structures surrounding the infrarenal aorta and locates the site of the aneurysm or dissection.
3. Clamps are placed above and below the site, and the aneurysm or dissection is repaired under direct visualization.
4. The provider incises the aorta to assist with placing an aorto-bi-iliac prosthesis, which extends from the aorta into both iliac arteries.
5. The aortic incisions are sutured, and any trauma resulting from the unsuccessful endovascular repair is also repaired.
6. The clamps are removed, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 34831 is performed when an endovascular repair of an infrarenal aortic aneurysm or dissection has been unsuccessful. The patient must be appropriately prepped and anesthetized for the open repair procedure. The provider must also determine the need for repair of associated arterial trauma resulting from the unsuccessful endovascular repair. This code specifically describes the use of an aorto-bi-iliac prosthesis for the repair.

5. When to use CPT code 34831

CPT code 34831 should be used when an endovascular repair of an infrarenal aortic aneurysm or dissection has been unsuccessful, and an open repair procedure is necessary. This code is specifically for cases where an aorto-bi-iliac prosthesis is used. It is important to note that this code should not be reported if a tube prosthesis (CPT 34830) or an aorto-bifemoral prosthesis (CPT 34832) is used instead.

6. Documentation requirements

To support a claim for CPT 34831, the provider must document the following information:

• Documentation of the unsuccessful endovascular repair
• Specific details of the open repair procedure, including the incision site, dissection, repair of the aneurysm or dissection, placement of the aorto-bi-iliac prosthesis, repair of associated arterial trauma, and closure of the incision
• Any complications or additional procedures performed during the open repair
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 34831, it is important to ensure that the procedure meets the criteria for this code. The provider must have attempted an endovascular repair that was unsuccessful before proceeding with the open repair. It is also important to use the appropriate code based on the type of prosthesis used. CPT 34831 should not be reported if a tube prosthesis (CPT 34830) or an aorto-bifemoral prosthesis (CPT 34832) is used instead. Additionally, it is important to follow any specific billing guidelines provided by payers or regulatory bodies.

8. Historical information

CPT 34831 was added to the Current Procedural Terminology system on January 1, 2001. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes an unsuccessful endovascular repair of an infrarenal aortic aneurysm. The provider performs an open repair using an aorto-bi-iliac prosthesis to repair the aneurysm and addresses the associated arterial trauma.
2. Following an unsuccessful endovascular repair of an infrarenal aortic dissection, the provider performs an open repair using an aorto-bi-iliac prosthesis to repair the dissection and addresses the associated arterial trauma.