CPT® Code 75953 | Case2Code

Official Description

Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal aortic or iliac artery aneurysm, pseudoaneurysm, or dissection, radiological supervision and interpretation

Common Language Description

The CPT® Code 75953 refers to the placement of a proximal or distal extension prosthesis specifically for the endovascular repair of an infrarenal aortic or iliac artery aneurysm, pseudoaneurysm, or dissection. This procedure is critical in managing vascular conditions that can lead to serious complications if left untreated. The term 'infrarenal' indicates that the aneurysm or dissection occurs below the renal arteries, which supply blood to the kidneys. The procedure involves the use of a prosthetic device that is deployed within the affected artery to reinforce the vessel wall and prevent rupture. Radiological supervision and interpretation are integral components of this procedure, ensuring that the placement of the prosthesis is performed accurately and safely. This includes the use of advanced imaging techniques such as angiography and fluoroscopy, which allow the physician to visualize the aorta and its branches, guide the prosthesis into position, and confirm its placement through intraprocedural imaging. The comprehensive nature of this procedure underscores the importance of precise imaging and skilled interpretation to achieve optimal patient outcomes.

1. Indications

The procedure associated with CPT® Code 75953 is indicated for the following conditions:

Aneurysm - The presence of an infrarenal aortic or iliac artery aneurysm, which is an abnormal dilation of the artery that can lead to rupture if not treated.
Pseudoaneurysm - A false aneurysm that occurs when blood leaks out of the artery and is contained by surrounding tissue, requiring intervention to prevent complications.
Dissection - A condition where there is a tear in the artery wall, leading to separation of the layers of the vessel, which can compromise blood flow and lead to serious health risks.

2. Procedure

The procedure for CPT® Code 75953 involves several critical steps to ensure successful placement of the extension prosthesis:

Step 1: Pre-Procedure Angiography - Prior to the deployment of the endovascular extension prosthesis, angiography of the aorta and its branches is performed. This imaging step is essential for assessing the anatomy and identifying the exact location of the aneurysm, pseudoaneurysm, or dissection.
Step 2: Road-Mapping Angiography - A road-mapping angiography is conducted to visualize the aortic or iliac artery anatomy. This step provides a detailed roadmap that guides the physician during the placement of the prosthesis.
Step 3: Fluoroscopic Guidance - Throughout the procedure, fluoroscopic guidance is utilized to assist in the placement of guidewires, catheters, and the extension prosthesis itself. This real-time imaging helps ensure accurate positioning and minimizes the risk of complications.
Step 4: Balloon Dilation - If necessary, balloon dilation is performed to properly seat the extension prosthesis within the artery. Fluoroscopic guidance is again employed during this step to ensure correct placement.
Step 5: Post-Deployment Imaging - After the prosthesis is deployed, a post-deployment aortogram or iliac artery angiogram is conducted. This imaging is crucial for evaluating the position of the prosthesis, checking for any endoleaks, and verifying the patency of adjacent arteries, including the renal, hypogastric, lumbar, and inferior mesenteric arteries.

3. Post-Procedure

Following the procedure, the physician is responsible for providing a written interpretation of all angiographic and fluoroscopic imaging performed during the procedure. This documentation is essential for ensuring that all findings are recorded and can be referenced for future care. Patients may be monitored for any immediate complications, and follow-up imaging may be scheduled to assess the long-term success of the prosthesis placement and the overall health of the vascular system.

Short Descr	ABDOM ANEURYSM ENDOVAS RPR
Medium Descr	PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I
Long Descr	Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal aortic or iliac artery aneurysm, pseudoaneurysm, 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	191 - Arterio- or venogram (not heart and head)