How To Use CPT Code 34848

CPT 34848 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 34848?

CPT 34848 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 unibody or modular infrarenal aortic endograft. The endografts are placed under radiological guidance to repair aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the visceral and infrarenal aorta. The procedure also includes the placement of four or more visceral artery endoprostheses, such as the superior mesenteric, celiac, and renal arteries.

2. Official Description

The official description of CPT code 34848 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 four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]).’

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 opposite femoral artery is cut into, a sheath is placed, and another guidewire is moved forward toward the ascending aorta.
6. A fenestrated endoprosthesis is introduced and fixated to achieve the desired repair of the aorta.
7. Under imaging guidance, four or more additional visceral artery prostheses are moved through the fenestration and fixed in place.
8. Aortography may be performed to view the treatment site.
9. A unibody or modular infrarenal aortic endograft is placed to repair the infrarenal abdominal aorta.
10. Angioplasty of the target area may be performed during the procedure.
11. The provider performs a complete examination of the blood vessels to ensure accurate fixation of the endografts and assess for any persistent blood flow, strictures, or blood clots.
12. The instruments are withdrawn, and the incision is closed in layers.

4. Qualifying circumstances

CPT 34848 is used for patients with conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions in the visceral and infrarenal abdominal aorta. The procedure is performed using a fenestrated visceral aortic endograft and a unibody or modular infrarenal aortic endograft. The patient must meet the criteria for endovascular repair and be under the care of a qualified healthcare professional.

5. When to use CPT code 34848

CPT code 34848 should be used when performing endovascular repair of the visceral aorta and infrarenal abdominal aorta using a fenestrated visceral aortic endograft and a unibody or modular infrarenal aortic endograft. This code should be reported when the procedure includes the placement of four or more visceral artery endoprostheses. It is important to review the documentation and descriptors of the codes in the range 34839-34848 to accurately select the appropriate code for the specific procedure performed.

6. Documentation requirements

To support a claim for CPT code 34848, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for endovascular repair
• Specific details of the procedure, including the use of a fenestrated visceral aortic endograft and a unibody or modular infrarenal aortic endograft
• Date of the procedure
• Start and end time of the procedure
• Details of any target zone angioplasty performed
• Documentation of the placement of four or more visceral artery endoprostheses
• Imaging guidance used during the procedure
• Results of aortography, if performed
• Examination findings of the blood vessels
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 34848, ensure that the procedure meets the criteria outlined in the code description. It is important to review the documentation and descriptors of the codes in the range 34839-34848 to accurately select the appropriate code for the specific procedure performed. CPT code 34848 should not be reported in conjunction with certain other codes, as specified in the notes. It is also important to consider any Medicare changes or guidelines that may apply to the billing of this code.

8. Historical information

CPT code 34848 was added to the Current Procedural Terminology system on January 1, 2014. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Similar codes to CPT 34848

Five similar codes to CPT 34848 include:

• CPT 34841: Endovascular repair of visceral aorta and infrarenal abdominal aorta with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft; including one visceral artery endoprosthesis (superior mesenteric, celiac, and/or renal artery[s]).