CPT® Code 34709

Add-On Code

Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure)

The CPT® Code 34709 refers to the placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) during an endovascular repair procedure targeting infrarenal abdominal aortic or iliac aneurysms. This procedure is essential when the common iliac artery is either too short or when an aneurysm is present, necessitating a limb extension. Additionally, it may be required when there is suboptimal fixation proximally due to low deployment of the main device or unfavorable aortic neck anatomy, which calls for an aortic cuff extension. The procedure involves a series of steps that include the introduction of a sheath into the common iliac artery(ies) in a retrograde manner, followed by the insertion of a guidewire and a delivery catheter to facilitate the deployment of the extension graft. This graft is designed to ensure a secure fit within the existing endograft and extend distally to the bifurcation of the internal and external iliac arteries. Furthermore, the procedure may involve the use of a bifurcated cuff to enhance blood flow to branch arteries. A low-pressure balloon is utilized to expand the junctions between grafts, ensuring a tight seal, while angiography is performed to confirm the correct placement and functionality of all graft components, as well as to check for any endoleaks or compromised blood flow to critical branch arteries. Code 34709 is reported separately in addition to the primary procedure codes and encompasses all necessary pre-procedure sizing, device selection, nonselective catheterizations, radiological supervision and interpretation, and any treatment zone angioplasty or stenting performed per vessel treated.