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Official Description

Endovascular placement of iliac artery occlusion device (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The endovascular placement of an iliac artery occlusion device is a specialized procedure aimed at addressing occlusive disease in the iliac arteries, particularly in the context of preparing for an endovascular repair of an abdominal aortic aneurysm. This procedure is indicated when one iliac artery remains patent, meaning it is open and unobstructed, while the other iliac artery is affected by occlusive disease, which can impede blood flow. To manage this condition effectively, the occluded artery is typically treated with a femoral-femoral prosthetic graft, which may be performed during the same surgical session or as a prior intervention. The primary goal of placing the iliac artery occlusion device is to prevent retrograde blood flow from the diseased artery into the aneurysm sac, thereby reducing the risk of complications associated with the aneurysm. The procedure involves the use of an introducer device that carries the occluder, which is advanced into the affected artery under fluoroscopic guidance, ensuring precise placement. Once the occluder is positioned correctly, contrast material is injected to confirm its placement and to ensure that the artery is completely occluded. If necessary, additional embolization materials may be used to achieve complete occlusion. Following the successful placement of the occlusion device, the introducer is removed, and the endovascular repair of the abdominal aortic aneurysm is performed as a separate, reportable procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The endovascular placement of an iliac artery occlusion device is indicated in specific clinical scenarios where there is a need to manage occlusive disease in the iliac arteries, particularly in preparation for subsequent endovascular repair of an abdominal aortic aneurysm. The following conditions warrant this procedure:

  • Patent Iliac Artery - One iliac artery must be patent, allowing for adequate blood flow, while the other is affected by occlusive disease.
  • Occlusive Disease - The presence of significant occlusive disease in one iliac artery that necessitates intervention to prevent complications during aneurysm repair.
  • Prior Treatment with Femoral-Femoral Graft - The occluded artery should have been treated with a separately reportable femoral-femoral prosthetic graft, either in a previous session or during the current surgical procedure.

2. Procedure

The procedure for the endovascular placement of an iliac artery occlusion device involves several critical steps to ensure successful deployment and functionality of the device. The following procedural steps are outlined:

  • Step 1: Preparation and Access - The procedure begins with the patient being positioned appropriately, and access to the femoral artery is obtained. This access is crucial for the introduction of the occlusion device.
  • Step 2: Guidewire Placement - A guidewire is advanced into the diseased iliac artery. This guidewire serves as a pathway for the introducer device that will carry the occluder.
  • Step 3: Introducer Device Advancement - The introducer device, which contains the occlusion device, is carefully advanced over the guidewire into the targeted diseased artery. Fluoroscopic guidance is utilized throughout this step to ensure accurate placement.
  • Step 4: Deployment of the Occluder - Once the introducer device is in the correct position, the occluder is deployed. This step is critical as it seals off the diseased artery to prevent retrograde blood flow.
  • Step 5: Verification of Position - A hand injection of contrast material is performed to confirm the correct positioning of the occluder and to ensure that complete arterial occlusion has been achieved.
  • Step 6: Additional Embolization - If necessary, additional embolization materials may be injected to ensure complete occlusion of the artery, further securing the effectiveness of the procedure.
  • Step 7: Removal of Introducer - After confirming successful occlusion, the introducer device is removed from the artery.
  • Step 8: Endovascular Repair - Following the placement of the occlusion device, the endovascular repair of the abdominal aortic aneurysm is performed as a separate, reportable procedure.

3. Post-Procedure

Post-procedure care following the endovascular placement of an iliac artery occlusion device involves monitoring the patient for any immediate complications, such as bleeding or vascular complications at the access site. Patients may require imaging studies to confirm the success of the occlusion and to ensure that there are no issues with the deployed device. Recovery may vary based on individual patient factors and the complexity of the overall surgical intervention, including the subsequent endovascular repair of the abdominal aortic aneurysm. Follow-up appointments are essential to assess the long-term effectiveness of the occlusion and to monitor for any potential complications.

Short Descr ENDOVAS ILIAC A DEVICE ADDON
Medium Descr EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
Long Descr Endovascular placement of iliac artery occlusion device (List separately in addition to code for primary procedure)
Status Code Active Code
Global Days ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC) 0 - Physician Service Code
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) 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 1
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck

This is an add-on code that must be used in conjunction with one of these primary codes.

34701 MPFS Status: Active Code APC C Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34702 MPFS Status: Active Code APC C Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34703 MPFS Status: Active Code APC C Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34704 MPFS Status: Active Code APC C Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34707 MPFS Status: Active Code APC C Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation)
34708 MPFS Status: Active Code APC C Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption)
34709 Addon Code MPFS Status: Active Code APC C 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)
34710 MPFS Status: Active Code APC C Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; initial vessel treated
34813 Addon Code MPFS Status: Active Code APC C CPT Assistant Article Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (List separately in addition to code for primary procedure)
34841 MPFS Status: Carrier Priced APC C Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal artery)
34842 MPFS Status: Carrier Priced APC C Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34843 MPFS Status: Carrier Priced APC C Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34844 MPFS Status: Carrier Priced APC C Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine 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)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2001-01-01 Added First appearance in code book in 2001.
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