Wiki AAA repair using 2 'extension' devices only - Please Help!

rmarkowitz

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I wanted to get input from other vascular coders as to how you would code an endo-AAA repair in which the physician used 2 typical ‘extension’ pieces to overlap and create an aortic only stent…”initial aortic device ends just proximal to the aortic bifurcation” and “the proximal portion of the second graft would end just at the renal arteries with the appropriate overlap with the initial device.”

• Would you code 34800 even though a unibody prosthesis was not used directly but the 2 pieces overlapped to essentially create one?

• Would you code 34825 (coded once, following ‘per vessel’ rule) since extension piece(s) was used even though this was not an extension of a previously placed endograft?

• Would you use an unlisted code?

I appreciate any input.
 
According to the Coding Strategies Interventional Radiology book you would use 34800.
An aorto-aortic tube prosthesis (34800) is a single piece prosthesis that resides only in the aorta & does not extend into the iliac artery. This type of prosthesis is not currently being manufactured. However, code 34800 can be assigned when the physician creates a tube prosthesis by inserting a series of extensions (without the main body of the prosthesis) to cover a short segment of dilated aorta.

M. Kaughman, CPC
 
Thank you!

Thank you for your input! I am happy that we are in agreement. After much consideration, I did code for 34800. Thanks again!
 
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