CPT® Code 0075T

Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel

The transcatheter placement of an extracranial vertebral artery stent(s) is a specialized, minimally invasive procedure aimed at treating conditions affecting the vertebral artery, which may include atherosclerotic stenosis, dissection, or aneurysm. The vertebral artery is a critical vessel that branches from the subclavian artery and is divided into four distinct sections, labeled V1 through V4. The first three sections, V1 to V3, are located extracranially within the cervical vertebrae, while V4 transitions into the intracranial space at the dura mater. Among these sections, V1 is frequently the site where sclerotic disease develops, whereas V3 is often associated with dissections due to its proximity to the dura mater. During the procedure, local anesthesia is typically administered, and patients are often pretreated with antiplatelet medications to mitigate the risk of stent thrombosis, which is a potential complication. Access to the vertebral artery is achieved through either an open cut down technique or a percutaneous approach. In the open technique, a surgical incision is made to expose the vessel, allowing for catheter insertion. Conversely, the percutaneous method involves the use of a large bore needle to cannulate the vessel directly through the skin, followed by catheter insertion. Fluoroscopic imaging is utilized throughout the procedure to guide the catheter into the subclavian artery and advance it to the point just before the vertebral artery's origin. Biplane road maps are generated to accurately identify the diseased area, which is then bypassed using a guidewire. Prior to the deployment of the stent, balloon angioplasty may be performed to prepare the vessel. Once the stent is satisfactorily placed, the catheter is removed. The CPT® code 0075T is specifically designated for the treatment of the initial vessel, while code 0076T is used for any additional vessels treated during the same session.