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The procedure described by CPT® Code 34825 involves the placement of a proximal or distal extension prosthesis specifically for the endovascular repair of an infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection. In simpler terms, this procedure is performed when the main endograft components used to repair the aorta or iliac artery are determined to be insufficient in length. This insufficiency is often identified during the initial endograft repair as an endoleak, which is a condition where blood leaks from the main graft into the surrounding area. The extension prosthesis serves as an additional component that extends the reach of the existing graft to effectively seal off the endoleak. The placement of the extension prosthesis can occur during the same surgical session as the initial repair or may be performed in a subsequent session if the endoleak is detected postoperatively. The procedure involves advancing a sheath that contains the extension prosthesis over a guide wire to the site of the endoleak. Once positioned, fluoroscopy is utilized to confirm the correct placement of the prosthesis. Following confirmation, the extension prosthesis is deployed and secured in place using a balloon catheter. To ensure that the endoleak is adequately sealed, contrast material is injected, allowing for visualization of the repair. This procedure is critical for maintaining the integrity of the vascular repair and preventing complications associated with aneurysms or dissections.
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The placement of a proximal or distal extension prosthesis for endovascular repair is indicated in the following situations:
The procedure for placing a proximal or distal extension prosthesis involves several critical steps:
After the placement of the extension prosthesis, patients are typically monitored for any immediate complications. This may include checking for signs of bleeding, infection, or any adverse reactions to the contrast material used during the procedure. Follow-up imaging studies may be scheduled to assess the integrity of the repair and ensure that the endoleak remains sealed. Patients may also receive instructions regarding activity restrictions and signs to watch for that could indicate complications. The overall recovery process will depend on the individual patient's health status and the complexity of the procedure performed.
| Short Descr | ENDOVASC EXTEND PROSTH INIT | Medium Descr | PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL | Long Descr | Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection; initial vessel | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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) | P2F - Major procedure, cardiovascular-Other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
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