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The CPT® Code 75958 refers to the placement of a proximal extension prosthesis specifically for the endovascular repair of the descending thoracic aorta. This procedure is indicated for various conditions affecting the aorta, including aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions. The procedure involves the use of advanced imaging techniques, particularly radiological supervision and interpretation, to ensure accurate placement and functionality of the prosthesis. During the procedure, comprehensive imaging is conducted, which includes angiography of the aorta and its branches prior to the deployment of the endovascular extension prosthesis. This imaging is crucial for visualizing the aortic anatomy and planning the intervention. The use of fluoroscopic guidance throughout the procedure aids in the precise placement of guidewires, catheters, and the prosthesis itself. Additionally, intraprocedural angiography is performed to confirm the correct positioning of the prosthesis, detect any potential endoleaks, and evaluate blood flow. A post-deployment aortogram is also conducted to assess the position of the extension prosthesis, check for endoleaks, and ensure the patency of the aorta. The physician is responsible for providing a written interpretation of all angiographic and fluoroscopic imaging performed during the procedure, ensuring comprehensive documentation and analysis of the intervention.
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The placement of a proximal extension prosthesis for endovascular repair of the descending thoracic aorta is indicated for the following conditions:
The procedure for the placement of a proximal extension prosthesis involves several critical steps to ensure successful endovascular repair of the descending thoracic aorta:
Following the procedure, careful monitoring is essential to assess the patient's recovery and the functionality of the placed prosthesis. The physician will review the written interpretation of all angiographic and fluoroscopic imaging to ensure that the procedure was successful and that there are no complications such as endoleaks. Patients may require follow-up imaging studies to monitor the aorta and the prosthesis over time, ensuring ongoing patency and stability. Any signs of complications or changes in the patient's condition should be addressed promptly to maintain optimal outcomes.
| Short Descr | XRAY PLACE PROX EXT THOR AO | Medium Descr | PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I | Long Descr | Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption), 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 | 2 | 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. | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 |
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Notes
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| 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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