How To Use CPT Code 75958

CPT 75958 describes the placement of a proximal extension prosthesis for endovascular repair of the descending thoracic aorta. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 75958?

CPT 75958 is used to report the placement of a proximal extension prosthesis for endovascular repair of the descending thoracic aorta. This code is specifically used when the provider performs imaging supervision and interpretation during the placement of the extension prosthesis at the site where previous repairs have been made, such as for an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption. It is important to note that this code should be reported for each proximal extension performed.

2. Official Description

The official description of CPT code 75958 is: ‘Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption), radiological supervision and interpretation.’

3. Procedure

1. The provider begins by making a small incision in the skin of the groin after the patient has been appropriately prepped and anesthetized.
2. Under fluoroscopic guidance, the provider uses a guide wire to introduce the extension prosthesis, typically a stent, at the site of the aneurysm or other artery abnormality in the descending thoracic aorta.
3. The provider then expands the stent at the site of weakness in the vessel.
4. If necessary, a balloon catheter may be introduced and inflated at the stent site to fully expand the stent and anchor the blood vessel.
5. Once the procedure is complete, the provider removes the catheter and closes the wound by suturing the skin incision.

4. Qualifying circumstances

CPT 75958 is used when the provider performs imaging supervision and interpretation during the placement of a proximal extension prosthesis for endovascular repair of the descending thoracic aorta. This procedure is typically performed when there is a leak at a previous artery graft site or when there is a need to repair abnormalities such as an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption in the descending thoracic aorta.

5. When to use CPT code 75958

CPT code 75958 should be used when the provider performs imaging supervision and interpretation during the placement of a proximal extension prosthesis for endovascular repair of the descending thoracic aorta. It is important to note that this code should be reported for each proximal extension performed.

6. Documentation requirements

To support a claim for CPT 75958, the provider must document the following information:

• Patient’s diagnosis and the need for the placement of a proximal extension prosthesis
• Details of the procedure, including the date, start and end time
• Specific abnormalities being repaired, such as an aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption
• Imaging guidance used during the procedure
• Progress made during the procedure and any complications encountered
• Signature of the provider performing the imaging supervision and interpretation

7. Billing guidelines

When billing for CPT 75958, ensure that the provider performing the imaging supervision and interpretation is reporting the code. It is important to note that this code should be reported for each proximal extension performed. Additionally, be aware of any payer policies regarding the use of modifiers for professional and technical components of the radiology service.

8. Historical information

CPT 75958 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition. It is worth noting that this code was added under the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs imaging supervision and interpretation during the placement of a proximal extension prosthesis for endovascular repair of an aneurysm in the descending thoracic aorta.
2. During a procedure, a provider uses fluoroscopic guidance to place a stent as a proximal extension for the endovascular repair of a pseudoaneurysm in the descending thoracic aorta, while performing imaging supervision and interpretation.
3. A provider performs imaging supervision and interpretation during the placement of a proximal extension prosthesis for endovascular repair of a dissection in the descending thoracic aorta.
4. During a procedure, a provider uses imaging guidance to place a stent as a proximal extension for the endovascular repair of a penetrating ulcer in the descending thoracic aorta, while performing imaging supervision and interpretation.
5. A provider performs imaging supervision and interpretation during the placement of a proximal extension prosthesis for endovascular repair of an intramural hematoma in the descending thoracic aorta.
6. During a procedure, a provider uses fluoroscopic guidance to place a stent as a proximal extension for the endovascular repair of a traumatic disruption in the descending thoracic aorta, while performing imaging supervision and interpretation.