CPT® Code 75952 | Case2Code

Official Description

Endovascular repair of infrarenal abdominal aortic aneurysm or dissection, radiological supervision and interpretation

Common Language Description

The CPT® Code 75952 refers to the endovascular repair of an infrarenal abdominal aortic aneurysm or dissection, specifically focusing on the radiological supervision and interpretation involved in the procedure. This procedure is critical for patients with an infrarenal abdominal aortic aneurysm, which is a localized enlargement of the abdominal aorta occurring below the renal arteries, or for those experiencing a dissection, where there is a tear in the aorta's inner layer. The role of radiological supervision and interpretation is essential throughout the endovascular repair process. It encompasses several key components, including the performance of angiography of the aorta and its branches prior to the deployment of the endovascular prosthesis. This initial imaging is crucial for assessing the anatomy and planning the repair. During the procedure, fluoroscopic guidance is utilized to ensure accurate placement of various components, such as guidewires, catheters, and the endovascular prosthesis itself. This guidance is vital for the successful delivery and positioning of the prosthesis, as well as for any necessary balloon dilation to secure the prosthesis in place. Additionally, intraprocedural angiography is conducted to confirm the correct positioning of the prosthesis, detect any potential endoleaks—where blood leaks back into the aneurysm sac—and evaluate the blood flow to the surrounding vessels. A post-deployment aortogram is also performed to assess the position of the prosthesis, check for endoleaks, and ensure the patency of critical arteries, including the renal, hypogastric, lumbar, and inferior mesenteric arteries. The physician is responsible for providing a comprehensive written interpretation of all angiographic and fluoroscopic imaging conducted during the procedure, which is essential for documenting the outcomes and guiding further patient management.

1. Indications

The procedure described by CPT® Code 75952 is indicated for patients diagnosed with an infrarenal abdominal aortic aneurysm or dissection. The following conditions may warrant the performance of this procedure:

Infrarenal Abdominal Aortic Aneurysm - A localized enlargement of the abdominal aorta occurring below the renal arteries, which poses a risk of rupture and requires intervention.
Aortic Dissection - A serious condition characterized by a tear in the aorta's inner layer, leading to separation of the aorta's layers and requiring urgent repair to prevent life-threatening complications.

2. Procedure

The endovascular repair procedure involves several critical steps, each essential for the successful treatment of the aneurysm or dissection:

Step 1: Pre-Procedure Angiography - Prior to the deployment of the endovascular prosthesis, angiography of the aorta and its branches is performed. This imaging is crucial for assessing the vascular anatomy and planning the repair strategy.
Step 2: Fluoroscopic Guidance - Throughout the procedure, fluoroscopic guidance is utilized to assist in the precise placement of guidewires, catheters, and the endovascular prosthesis. This real-time imaging ensures that all components are accurately positioned within the vascular system.
Step 3: Intraprocedural Angiography - During the procedure, intraprocedural angiography is conducted to confirm the correct positioning of the prosthesis. This step is vital for detecting any endoleaks and evaluating the blood flow to the surrounding vessels.
Step 4: Balloon Dilation - If necessary, balloon dilation is performed to properly seat the prosthesis. Fluoroscopic guidance is again employed to ensure the correct placement and inflation of the balloon.
Step 5: Post-Deployment Aortogram - After the deployment of the prosthesis, a post-deployment aortogram is performed. This imaging assesses the position of the prosthesis, checks for any endoleaks, and verifies the patency of critical arteries, including the renal, hypogastric, lumbar, and inferior mesenteric arteries.
Step 6: Documentation - Finally, the physician provides a written interpretation of all angiographic and fluoroscopic imaging conducted during the procedure, which is essential for documenting the outcomes and guiding further patient management.

3. Post-Procedure

Following the endovascular repair of the infrarenal abdominal aortic aneurysm or dissection, patients typically require monitoring for any complications, such as endoleaks or changes in blood flow. The physician will review the results of the post-deployment aortogram to ensure the prosthesis is correctly positioned and functioning as intended. Patients may also need follow-up imaging studies to assess the long-term success of the repair and monitor for any potential issues. Comprehensive documentation of the procedure and its outcomes is crucial for ongoing patient care and management.

Short Descr	ENDOVASC REPAIR ABDOM AORTA
Medium Descr	EVASC RPR INFRARENAL AAA/DISSECTION RS&I
Long Descr	Endovascular repair of infrarenal abdominal aortic aneurysm or dissection, radiological supervision and interpretation
Status Code	Active 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)	I1F - Standard imaging - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	226 - Other diagnostic radiology and related techniques