How To Use CPT Code 34846

CPT 34846 describes the endovascular repair of the visceral aorta and infrarenal abdominal aorta using a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft. 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 34846?

CPT 34846 is a code used to describe the endovascular repair of the visceral aorta and infrarenal abdominal aorta. This procedure involves the use of a fenestrated visceral aortic endograft and a concomitant unibody or modular infrarenal aortic endograft. The purpose of this procedure is to treat conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the visceral and infrarenal abdominal aorta.

2. Official Description

The official description of CPT code 34846 is: ‘Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]).’

3. Procedure

1. The procedure begins with the patient being positioned and prepped, and anesthesia is administered.
2. The provider makes a small surgical incision 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. A fenestrated endoprosthesis is introduced and fixated to achieve the desired repair of the aorta.
7. Under imaging guidance, two additional visceral artery prostheses are moved through the fenestrations and fixed in place.
8. Aortography may be performed to view the treatment site.
9. The provider also places a unibody or modular infrarenal aortic endograft to repair the infrarenal abdominal aorta.
10. Angioplasty of the target area may be performed during the encounter.
11. 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 in between the arteries.
12. Once everything is inspected, the provider withdraws the instruments and finally closes the incision in layers.