CPT® Code 35484

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The CPT® Code 35484 refers to a specific medical procedure known as transluminal peripheral atherectomy, which is performed on the brachiocephalic trunk or its branches. This procedure is designed to remove plaque buildup from the arterial walls, thereby restoring blood flow. The process begins with the preparation and incision of the skin over the access artery, allowing for direct access to the artery itself. Once the artery is exposed, a small nick is made, and a sheath is inserted to facilitate further access. A guidewire is then introduced and advanced through the access artery to the site of the occlusion. The atherectomy catheter, which is a specialized device used for this procedure, is advanced over the guidewire. This catheter features a cutting piston that operates through a window on one side, enabling it to shave away plaque from the arterial wall. As the plaque is removed, it is collected in the device for extraction once the procedure is completed. The physician may perform multiple passes with the atherectomy device to ensure thorough removal of the plaque and achieve optimal results. Following the atherectomy, the device is exchanged for a guidewire, and an angiography catheter is introduced to assess the success of the procedure. Contrast material is injected, and completion angiography is conducted to confirm that the vessel is patent. Finally, the angiography catheter is withdrawn, and the access artery is repaired, concluding with the closure of the skin incision. This procedure is coded as 35484 for each vessel treated, highlighting its specificity and the importance of accurate coding in medical billing and documentation.