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The transcatheter placement of an extracranial vertebral artery stent(s) is a specialized, minimally invasive procedure aimed at treating conditions affecting the vertebral artery, which may include atherosclerotic stenosis, dissection, or aneurysm. The vertebral artery is a critical vessel that branches from the subclavian artery and is divided into four distinct sections, labeled V1 through V4. The first three sections, V1 to V3, are located extracranially within the cervical vertebrae, while V4 transitions into the intracranial space at the dura mater. Among these sections, V1 is frequently the site where sclerotic disease develops, whereas V3 is often associated with dissections due to its proximity to the dura mater. During the procedure, local anesthesia is typically administered, and patients are often pretreated with antiplatelet medications to mitigate the risk of stent thrombosis, which is a potential complication. Access to the vertebral artery is achieved through either an open cut down technique or a percutaneous approach. In the open technique, a surgical incision is made to expose the vessel, allowing for catheter insertion. Conversely, the percutaneous method involves the use of a large bore needle to cannulate the vessel directly through the skin, followed by catheter insertion. Fluoroscopic imaging is utilized throughout the procedure to guide the catheter into the subclavian artery and advance it to the point just before the vertebral artery's origin. Biplane road maps are generated to accurately identify the diseased area, which is then bypassed using a guidewire. Prior to the deployment of the stent, balloon angioplasty may be performed to prepare the vessel. Once the stent is satisfactorily placed, the catheter is removed. The CPT® code 0075T is specifically designated for the treatment of the initial vessel, while code 0076T is used for any additional vessels treated during the same session.
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The transcatheter placement of extracranial vertebral artery stent(s) is indicated for patients presenting with specific vascular conditions that compromise the integrity and function of the vertebral artery. These indications include:
The procedure for transcatheter placement of extracranial vertebral artery stent(s) involves several critical steps to ensure successful intervention. The following outlines the procedural steps:
After the transcatheter placement of the extracranial vertebral artery stent(s), patients are typically monitored for any immediate complications. Post-procedure care may include observation for signs of bleeding, vascular complications, or neurological deficits. Patients are often advised to continue antiplatelet therapy as prescribed to prevent thrombotic events. Follow-up imaging may be scheduled to assess the patency of the stent and the overall condition of the vertebral artery. Recovery time can vary, but many patients are able to resume normal activities within a short period, depending on their overall health and the complexity of the procedure.
| Short Descr | PERQ STENT/CHEST VERT ART | Medium Descr | TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL | Long Descr | Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | 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) | 6 - Therapeutic Radiology | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 59 - Other OR procedures on vessels of head and neck |
This is a primary code that can be used with these additional add-on codes.
| 0076T | Addon Code MPFS Status: Carrier Priced APC C PUB 100 CPT Assistant Article Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (List separately in addition to code for primary procedure) | 37252 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure) | 37253 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2015-01-01 | Changed | Description Changed |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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