CPT® Code 0081T

Code deleted, see 34841-34848

Official Description

Placement of visceral extension prosthesis for endovascular repair of abdominal aortic aneurysm involving visceral vessels, each visceral branch, radiological supervision and interpretation (List separately in addition to code for primary procedure)

Common Language Description

The CPT® Code 0081T refers to the placement of a visceral extension prosthesis specifically for the endovascular repair of an abdominal aortic aneurysm that involves visceral vessels. This procedure is critical in managing complex abdominal aortic aneurysms, particularly when the aneurysm extends into the branches that supply vital organs. The term "visceral extension prosthesis" indicates that the prosthetic device is designed to extend into the visceral branches, which may include arteries supplying the kidneys, intestines, and other abdominal organs. The procedure encompasses several key components, including radiological supervision and interpretation, which are essential for ensuring the accurate placement and functionality of the prosthesis. During the procedure, various imaging techniques are employed, such as angiography, to visualize the aorta and its branches before the deployment of the endovascular prosthesis. This imaging is crucial for planning the intervention and ensuring that the prosthesis is correctly positioned. Fluoroscopic guidance is utilized throughout the procedure to assist in the precise placement of guidewires, catheters, and the prosthesis itself. Additionally, intraprocedural angiography is performed to confirm the correct positioning of the prosthesis, detect any potential endoleaks, and evaluate the blood flow through the affected vessels. A post-deployment aortogram is also conducted to assess the position of the prosthesis, check for endoleaks, and ensure the patency of the renal, hypogastric, lumbar, and inferior mesenteric arteries. The physician is responsible for providing a comprehensive written interpretation of all angiographic and fluoroscopic imaging performed during the procedure. This code is listed separately in addition to the primary procedure code for the placement of the abdominal aortic prosthesis with visceral branch involvement, which is designated by CPT® Code 0080T.

1. Indications

The placement of a visceral extension prosthesis for endovascular repair of abdominal aortic aneurysm involving visceral vessels is indicated in the following scenarios:

Abdominal Aortic Aneurysm: The procedure is performed when there is an abdominal aortic aneurysm that extends into the visceral branches, necessitating the use of a prosthesis to ensure proper blood flow and prevent rupture.
Visceral Vessel Involvement: Indications include cases where the aneurysm affects the arteries supplying vital organs, such as the kidneys and intestines, requiring specialized intervention to maintain organ perfusion.

2. Procedure

The procedure for the placement of a visceral extension prosthesis involves several critical steps, each designed to ensure the successful repair of the abdominal aortic aneurysm while preserving the function of the visceral vessels.

Step 1: Pre-Procedure Imaging Prior to the intervention, a comprehensive angiography of the aorta and its branches is performed. This imaging is essential for assessing the anatomy and planning the deployment of the endovascular prosthesis. The road-mapping angiography provides a detailed view of the aortic anatomy, which guides the subsequent steps of the procedure.
Step 2: Fluoroscopic Guidance Throughout the procedure, fluoroscopic guidance is utilized to assist in the accurate placement of guidewires, catheters, and the endovascular prosthesis. This real-time imaging allows the physician to navigate the complex vascular anatomy and ensure precise positioning of the devices.
Step 3: Deployment of the Prosthesis The endovascular components are delivered to the site of the aneurysm under fluoroscopic guidance. This step is critical for ensuring that the prosthesis is correctly positioned within the aorta and the visceral branches.
Step 4: Intraprocedural Angiography After the prosthesis is deployed, intraprocedural angiography is performed to confirm the position of the prosthesis, detect any endoleaks, and evaluate the blood flow through the visceral vessels. This step is vital for ensuring the success of the repair and the integrity of the vascular system.
Step 5: Post-Deployment Aortogram Following the deployment, a post-deployment aortogram is conducted to assess the position of the prosthesis, check for any endoleaks, and verify the patency of the renal, hypogastric, lumbar, and inferior mesenteric arteries. This final imaging step ensures that the procedure has achieved its intended outcomes.

3. Post-Procedure

After the procedure, the patient is monitored for any complications, including potential endoleaks or issues related to the placement of the prosthesis. The physician will provide a written interpretation of all angiographic and fluoroscopic imaging performed during the procedure, which is essential for documenting the outcomes and guiding any necessary follow-up care. Patients may require additional imaging studies in the future to ensure the continued patency of the visceral vessels and the integrity of the prosthesis. Recovery may vary based on individual patient factors, but close monitoring is crucial to address any post-procedural concerns promptly.

Short Descr	ENDOVASC VISC EXTNSN S&I
Medium Descr	PLMT VISC XTN PROSTH EVASC RPR AAA EA VISC RS&I
Long Descr	Placement of visceral extension prosthesis for endovascular repair of abdominal aortic aneurysm involving visceral vessels, each visceral branch, radiological supervision and interpretation (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Inpatient Procedures, not paid under OPPS
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	61 - Other OR procedures on vessels other than head and neck