How To Use CPT Code 34843

CPT 34843 describes the endovascular repair of the visceral aorta using a fenestrated visceral aortic endograft and 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 34843?

CPT 34843 is a code used to describe the endovascular repair of the visceral aorta. This procedure involves the deployment of a fenestrated visceral aortic endograft, which is a mesh tube-like device, to repair various conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the upper abdominal aorta. The repair also includes the placement of three visceral artery endoprostheses, specifically the superior mesenteric, celiac, and/or renal arteries. The procedure is performed under radiological guidance and includes all associated radiological supervision and interpretation.

2. Official Description

The official description of CPT code 34843 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 three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]).’

3. Procedure

1. The patient is positioned and prepped, and anesthesia is administered.
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 opposite femoral artery is cut into, a sheath is placed, and another guidewire is moved forward toward the ascending aorta.
6. Aortography may be performed to view the treatment site.
7. A special device is introduced, and the fenestrated endoprosthesis is moved into place and fixated to repair the aorta.
8. Under imaging guidance, the three additional visceral artery prostheses are inserted through the fenestrations and fixed in place.
9. Angioplasty of the target area may be performed during the encounter.
10. A complete examination of the blood vessels is performed to analyze the accurate fixation of the endografts and any potential complications.
11. The instruments are withdrawn, and the incision is closed in layers.

4. Qualifying circumstances

CPT 34843 is used for patients with conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the visceral aorta. The procedure is performed by deploying a fenestrated visceral aortic endograft and placing three visceral artery endoprostheses. The patient must meet the specific criteria for these conditions and require endovascular repair. The procedure must be performed under radiological guidance, and the associated radiological supervision and interpretation must be included.

5. When to use CPT code 34843

CPT code 34843 should be used when an endovascular repair of the visceral aorta is performed using a fenestrated visceral aortic endograft and three visceral artery endoprostheses. This code is appropriate for cases involving aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the upper abdominal aorta. It is important to ensure that the procedure is performed under radiological guidance and includes all associated radiological supervision and interpretation.

6. Documentation requirements

To support a claim for CPT code 34843, the following documentation is required:

• Patient’s diagnosis and the need for endovascular repair of the visceral aorta
• Details of the fenestrated visceral aortic endograft used
• Date and duration of the procedure
• Specific arteries involved and the placement of three visceral artery endoprostheses
• Imaging guidance used during the procedure
• Target zone angioplasty, if performed
• Results of the examination of the blood vessels and any complications
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 34843, ensure that the procedure meets the criteria for endovascular repair of the visceral aorta using a fenestrated visceral aortic endograft and three visceral artery endoprostheses. The procedure must be performed under radiological guidance, and the associated radiological supervision and interpretation should be included. It is important to review the documentation and descriptors for codes 34841 to 34848 to accurately select the appropriate code based on the specific details of the procedure.

8. Historical information

CPT code 34843 was added to the Current Procedural Terminology system on January 1, 2014. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes endovascular repair of a visceral aorta aneurysm using a fenestrated visceral aortic endograft and three visceral artery endoprostheses.