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Official Description

Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 75957 refers to the endovascular repair of the descending thoracic aorta, which is a critical procedure performed to address various vascular conditions. This procedure is indicated for patients suffering from conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions of the aorta. The endovascular approach allows for a minimally invasive repair, which is advantageous compared to traditional open surgical methods. The procedure involves the placement of an initial endoprosthesis, which is a type of stent graft, and may include additional descending thoracic aortic extensions if necessary, extending to the level of the celiac artery origin. During the procedure, radiological supervision and interpretation are essential components, ensuring that the placement of the endoprosthesis is accurate and effective. This includes performing angiography of the aorta and its branches prior to the deployment of the endovascular prosthesis, as well as fluoroscopic guidance throughout the procedure. The use of imaging techniques allows for real-time visualization of the aortic anatomy, facilitating the precise placement of guidewires, catheters, and the endovascular prosthesis itself. Additionally, intraprocedural angiography is conducted to confirm the correct positioning of the prosthesis, detect any potential endoleaks, and evaluate blood flow. The comprehensive nature of this procedure underscores its importance in managing complex aortic conditions while minimizing patient recovery time and associated risks.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The endovascular repair of the descending thoracic aorta using CPT® Code 75957 is indicated for the following conditions:

  • Aneurysm - A localized enlargement of the aorta that can lead to rupture if not treated.
  • Pseudoaneurysm - A false aneurysm that occurs when blood leaks out of the artery but is contained by surrounding tissue.
  • Dissection - A serious condition where there is a tear in the inner layer of the aorta, leading to separation of the layers of the aortic wall.
  • Pentrating Ulcer - An ulcer that penetrates the aortic wall, which can lead to serious complications such as bleeding or rupture.
  • Intramural Hematoma - A collection of blood within the wall of the aorta, which can compromise the integrity of the vessel.
  • Traumatic Disruption - Injury to the aorta resulting from trauma, which may require urgent repair to prevent life-threatening complications.

2. Procedure

The procedure for endovascular repair of the descending thoracic aorta involves several critical steps:

  • Step 1: Pre-Procedure Imaging - Prior to the intervention, a comprehensive angiography of the aorta and its branches is performed. This imaging is crucial for assessing the anatomy and planning the placement of the endoprosthesis.
  • Step 2: Accessing the Aorta - The procedure typically begins with the insertion of a catheter into the femoral artery, which provides access to the aorta. This access point is essential for delivering the endovascular prosthesis.
  • Step 3: Deployment of the Endoprosthesis - The initial endoprosthesis is carefully navigated through the vascular system to the site of the aortic condition. Fluoroscopic guidance is utilized to ensure accurate placement.
  • Step 4: Placement of Extensions - If necessary, additional descending thoracic aortic extensions are deployed to ensure complete coverage of the affected area, extending to the level of the celiac artery origin.
  • Step 5: Intraprocedural Angiography - Throughout the procedure, intraprocedural angiography is performed to confirm the position of the prosthesis, check for endoleaks, and evaluate the blood flow in the aorta.
  • Step 6: Post-Deployment Angiogram - After the deployment of the endoprosthesis and any extensions, a post-deployment angiogram is conducted to assess the position of the prosthesis, verify patency, and check for any endoleaks.
  • Step 7: Documentation - The physician provides a written interpretation of all angiographic and fluoroscopic imaging, which is essential for medical records and future patient management.

3. Post-Procedure

After the endovascular repair of the descending thoracic aorta, patients typically undergo monitoring to assess for any complications. This may include checking for signs of endoleaks or other issues related to the prosthesis. Patients are often advised on activity restrictions and follow-up imaging studies to ensure the continued success of the repair. The recovery period can vary, but the minimally invasive nature of the procedure generally allows for a quicker recovery compared to traditional surgical methods. Ongoing follow-up care is essential to monitor the aorta and the integrity of the endoprosthesis over time.

Short Descr XRAY ENDOVASC THOR AO REPR
Medium Descr EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I
Long Descr Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation
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) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I4B - Imaging/procedure - other
MUE 1
CCS Clinical Classification 191 - Arterio- or venogram (not heart and head)

This is a primary code that can be used with these additional add-on codes.

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.
GC This service has been performed in part by a resident under the direction of a teaching physician
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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).
CR Catastrophe/disaster related
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Medium descriptor changed per AMA 2013 corrections document.
2011-01-01 Changed Short description changed.
2006-01-01 Added First appearance in code book in 2006.
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