How To Use CPT Code 34832

CPT 34832 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 34832?

CPT 34832 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 and places an aorto-bifemoral prosthesis to restore blood flow.

2. Official Description

The official description of CPT code 34832 is: ‘Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral 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-bifemoral prosthesis, which extends from the aorta into both femoral arteries.
5. The aortic incisions are sutured, and any trauma from the unsuccessful endovascular repair is repaired.
6. The clamps are removed, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 34832 is performed when an endovascular repair of an infrarenal aortic aneurysm or dissection has been unsuccessful. The patient must have associated arterial trauma that requires repair. The procedure is typically performed on patients who are appropriately prepped and anesthetized for surgery.

5. When to use CPT code 34832

CPT code 34832 should be used when an open repair of an infrarenal aortic aneurysm or dissection, along with the repair of associated arterial trauma, is performed following an unsuccessful endovascular repair. This code should not be used for initial repairs or repairs that do not involve an unsuccessful endovascular procedure.

6. Documentation requirements

To support a claim for CPT 34832, the provider must document the following information:

• Reason for the open repair, including the unsuccessful endovascular repair
• Details of the procedure, including the incision site, repair of the aneurysm or dissection, and placement of the aorto-bifemoral prosthesis
• Repair of any associated arterial trauma
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 34832, ensure that the procedure meets the criteria for an unsuccessful endovascular repair and includes the repair of associated arterial trauma. It is important to document the details of the procedure and any complications or additional procedures performed. CPT code 34832 should not be reported with other codes for endovascular repairs or initial repairs.

8. Historical information

CPT 34832 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, including the repair of associated arterial trauma, using an aorto-bifemoral prosthesis.
2. Following an unsuccessful endovascular repair of an infrarenal aortic dissection, the provider performs an open repair and repairs the associated arterial trauma using an aorto-bifemoral prosthesis.
3. An individual has an unsuccessful endovascular repair of an infrarenal aortic aneurysm. The provider performs an open repair, including the repair of associated arterial trauma, using an aorto-bifemoral prosthesis.
4. After an unsuccessful endovascular repair of an infrarenal aortic dissection, the provider performs an open repair and repairs the associated arterial trauma using an aorto-bifemoral prosthesis.
5. A patient undergoes an unsuccessful endovascular repair of an infrarenal aortic aneurysm. The provider performs an open repair, including the repair of associated arterial trauma, using an aorto-bifemoral prosthesis.