CPT® Code 34820

Add-On Code

Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 34820 involves the surgical exposure of the iliac artery through an abdominal or retroperitoneal incision. This exposure is necessary for the delivery of an endovascular prosthesis or for performing iliac occlusion during endovascular therapy, particularly in the context of endovascular abdominal aortic aneurysm repair. The process begins with an incision made in the lower abdomen or retroperitoneum, followed by careful dissection of the surrounding tissues to access the iliac artery. During this dissection, it is crucial to protect adjacent structures such as veins, nerves, and the ureter to prevent complications. The procedure requires meticulous control of any bleeding, which can be achieved through techniques such as ligation or electrocautery. Once the iliac artery is adequately exposed, it is secured with vessel loops to maintain visibility and access. The artery is then clamped and incised, allowing for the introduction of guidewires and sheaths necessary for the subsequent endovascular procedure or iliac occlusion. After the endovascular intervention is completed, the iliac artery is repaired, and the incision in the skin and soft tissue is closed in layers. This procedure is performed unilaterally and is reported separately in addition to the code for the primary procedure, highlighting its distinct nature and the specific surgical intervention involved.