How To Use CPT Code 34841

CPT 34841 describes the endovascular repair of the visceral aorta using a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation. 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 34841?

CPT 34841 can be used to describe the endovascular repair of the visceral aorta using a fenestrated visceral aortic endograft. This code is used when the provider performs the procedure and includes all associated radiological supervision and interpretation. The procedure involves repairing an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption in the visceral aorta by deploying the fenestrated endograft and placing a single visceral artery endoprosthesis.

2. Official Description

The official description of CPT code 34841 is: ‘Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal artery).’

3. Procedure

1. The provider positions and preps the patient and administers anesthesia.
2. A small surgical incision is made near the groin area to access a femoral artery.
3. An endovascular device is introduced, and a guidewire is advanced from the femoral artery into the ascending aorta.
4. Under imaging guidance, the provider identifies the location of the aneurysm or other vascular problem and guides the wire through the site to a point above the renal arteries.
5. The provider cuts into the opposite femoral artery, places a sheath, and advances another guidewire toward the ascending aorta.
6. Aortography may be performed to view the treatment site.
7. The provider introduces a special device and moves the fenestrated endoprosthesis into place, fixating it to achieve the desired repair of the aorta.
8. Under imaging guidance, the visceral artery prosthesis is inserted through a fenestration and fixed in place.
9. Angioplasty of the target area may be performed during the encounter.
10. The provider performs a complete examination of the blood vessels to analyze the accurate fixation of the endografts and presence or absence of any persistent blood flow or any stricture or blood clot between the arteries.
11. The instruments are withdrawn, and the incision is closed in layers.

4. Qualifying circumstances

CPT 34841 is used for patients with an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption in the visceral aorta. The procedure is performed by deploying a fenestrated visceral aortic endograft and placing a single visceral artery endoprosthesis. The patient must meet the specific criteria for the procedure, and the provider must document the medical necessity for performing the repair.

5. When to use CPT code 34841

CPT code 34841 should be used when the provider performs the endovascular repair of the visceral aorta using a fenestrated visceral aortic endograft and places a single visceral artery endoprosthesis. This code is appropriate for cases involving aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the visceral aorta.

6. Documentation requirements

To support a claim for CPT 34841, the provider must document the following information:

• Diagnosis of the patient’s condition requiring the endovascular repair
• Details of the procedure performed, including the use of a fenestrated visceral aortic endograft and placement of a single visceral artery endoprosthesis
• Date of the procedure
• Start and end time of the procedure
• Imaging guidance used during the procedure
• Any additional procedures performed, such as target zone angioplasty
• Results of the examination of the blood vessels
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 34841, ensure that the procedure meets the specific criteria for the code. The provider should document the medical necessity for performing the endovascular repair and include all associated radiological supervision and interpretation. It is important to review the documentation and descriptors for codes 34839 to 34848 to choose the most appropriate code for the specific case. CPT code 34841 should not be reported with other codes for endovascular repair of the visceral aorta unless multiple visceral artery endoprostheses were used.

8. Historical information

CPT 34841 was added to the Current Procedural Terminology system on January 1, 2014. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes endovascular repair of a visceral aortic aneurysm using a fenestrated endograft and a single visceral artery endoprosthesis.
2. The provider performs endovascular repair of a traumatic disruption in the visceral aorta using a fenestrated visceral aortic endograft and places a single visceral artery endoprosthesis.