CPT® Code 0076T

Add-On Code

Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (List separately in addition to code for primary procedure)

The transcatheter placement of 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 segments, designated as V1 through V4. The first three segments, V1 to V3, are located extracranially in the cervical region, while V4 transitions into the intracranial space at the dura mater. Among these segments, V1 is frequently the site of atherosclerotic disease, whereas V3 is often associated with dissections. During the procedure, local anesthesia is typically administered, and patients are 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 access the vessel 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 locate the diseased area, which is then bypassed using a guidewire. Prior to stent deployment, balloon angioplasty may be performed to prepare the vessel. Once the stent is satisfactorily placed, the catheter is withdrawn. It is important to note that CPT® Code 0075T is designated for the treatment of the first vessel, while CPT® Code 0076T is used to report each additional vessel treated during the procedure.