How To Use CPT Code 34844

CPT 34844 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 34844?

CPT 34844 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 four or more visceral artery endoprostheses, which are prosthetic devices used to support and reinforce the weakened artery walls.

2. Official Description

The official description of CPT code 34844 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 four or more 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 provider cuts into the opposite femoral artery, places a sheath, and moves forward another guidewire 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, four or more 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 ensure accurate fixation of the endografts and to check for any persistent blood flow, strictures, or blood clots.
11. The instruments are withdrawn, and the incision is closed in layers.