CPT 2006 Update:
Start Your Year Ready to Code Endovascular Repairs
Published on Sun Jan 01, 2006
Bonus: Discover how to handle fluoroscopy codes
CPT 2006 adds a whole new section for "Endovascular Repair of Descending Thoracic Aorta," which means you'll be throwing out Category III codes 0033T-0040T in favor of 33880-33891. But make sure you know what services these codes do--and do not--include. Learn the New Codes You'll apply these codes when your cardiologist repairs the descending thoracic aorta using an endovascular graft.
"Clinically, this is similar to the procedures doctors have been performing for years to treat abdominal aortic aneurysm (AAA). The key difference is that the anatomic area being treated is in the thoracic aorta--the portion of aorta between the abdominal aorta and the aortic arch," says Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition in Matthews, N.C.
The new codes include device introduction, manipulation, positioning and deployment.
For example, you'll be able to bill for the endovascular thoracic aorta repair with coverage of left subclavian artery origin (33880, Endovascular repair of descending thoracic aorta [e.g., aneurysm, pseudo-aneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption]; involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension[s], if required, to level of celiac artery origin) or without (33881, ...not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension[s], if required, to level of celiac artery origin).
Heads up: Unlike the traditional AAA repair codes, these endovascular thoracic repair codes include any distal extensions deployed at the time of the procedure.
Second, if your cardiologist deems proximal extensions necessary at the time of the initial graft deployment, you should separately report them with new codes 33883 (Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta [e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption]; initial extension) and +33884 (...each additional proximal extension [list separately in addition to code for primary procedure]).
Note this difference: "These codes are unlike the existing AAA extension graft codes (34825-34826) in that you should separately code each graft your cardiologist deploys rather than 'each vessel,' as is the case with the AAA codes," Collins says. Similarly, you should separately report distal extension prostheses deployed after the initial procedure with 33886 (Placement of distal extension prosthesis[s] delayed after endovascular repair of descending thoracic aorta).
This section also includes surgical transposition of the subclavian to the carotid artery with endovascular repair of the descending thoracic (33889, Open subclavian to carotid artery transposition performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision, unilateral) and a bypass graft with an endovascular repair of the descending thoracic (33891, Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision). What [...]
