SURGICAL EXPOSURE OF ARTERY CPT CODE APPLICABLE MODIFIERS*

Open femoral exposure 34812 -50 -62 -80 -82 -AS

Open iliac exposure 34820 -50 -62 -80 -82 -AS

Open iliac exposure with creation of conduit 34833 -50 -62 -80 -82 -AS

Open brachial exposure 34834 -50 -62 -80 -82 -AS

PLACEMENT OF WIRES/CATHETERS/SHEATHS CPT CODE APPLICABLE MODIFIERS*

Catheter/sheath placement into aorta; nonselective 36200 -50 — — — —

Catheter/sheath placement into renals; selective 36245 -50 — — — —

PLACEMENT AND DEPLOYMENT OFENDOLUMINAL GRAFT (ELG) CPT CODE APPLICABLE MODIFIERS*

Endo AAA repair with modular bifurcateddevice (1 docking limb) 90-day global period 34802 — -62 -80 -82 -AS

Endo AAA repair with modular bifurcated device (2 docking limbs) 90-day global period 34803 — -62 -80 -82 -AS

Endo AAA repair with AUI device; 90-day global period** 34805 — -62 -80 -82 -AS

Rad. S&I: endo AAA repair 75952-26 — — — — —

Extension prosthesis; initial vessel 34825 — -62 -80 -82 -AS

Extension prosthesis; each additional vessel +34826 — -62 -80 -82 -AS

Rad. S&I: extension prosthesis 75953-26 — — — — —

OPEN SURGICAL SALVAGE CPT CODE APPLICABLE MODIFIERS*

Open repair endo salvage; tube prosthesis 34830 — -62 -80 — -AS

Open repair endo salvage; aorto-bi-iliacprosthesis

34831 — -62 -80 — -AS

Open repair endo salvage; aorto-bifemoralprosthesis

34832 — -62 -80 — -AS

ANCILLARY PROCEDURES CPT CODE APPLICABLE MODIFIERS*

IVUS noncoronary, initial vessel +37252 — — — — —

IVUS noncoronary, additional vessel +37253 — — — — —

Arterial embolization or coiling (non-hemorrhage or tumor) 37242 — — — — —

Non-coronary arterial stent, initial artery 37236 — — -80 -82 —

Non-coronary arterial stent, add’l artery +37237 — — — — —

Placement of sensor in aneurysmal sac +34806 — -62 -80 -82 -AS

Endo iliac artery occlusive device +34808 — -62 -80 -82 -AS

Fem-fem prosthetic graft +34813 — -62 -80 -82 -AS

Endo IAA repair with prosthesis 34900 -50 -62 -80 -82 -AS

Rad S&I: endo IAA repair 75954-26 — — — — —

Repair blood vessel, direct, lower extremity 35226 -50 -62 -80 -82 -AS

Thromboedarterectomy, incl. patch graft, common femoral 35371 -50 -62 -80 -82 -AS

Aortic fixation (unlisted procedure, vascular surgery) 37799 — — — — —

MODIFIER DESCRIPTION

Professional component -26

Bilateral procedure -50

Multiple procedures (50% reduction) -51

Distinct procedure service -59

Distinct service – separate encounter -XE

Distinct service – separate organ/structure -XS

Distinct service – different practitioner -XP

Distinct service – unique, non-overlapping -XU

Cosurgeons: separate group and specialty (62.5%) -62

Return to OR for related proc during post-op period -78

Return to OR for unrelated proc during post-op period -79

Assistant surgeon (16%) -80

Assistant surgeon (resident surgeon unavailable) -82

Assistant-at-surgery (non-physician practitioner) (85% of 16%) -AS

PHYSICIAN NAME:

DATE OF SERVICE:

PATIENT NAME:

ENDOVASCULAR AAA REPAIR CODING GUIDE

*Othercodingmodifiersmayapply.**Theplacementofaniliaclimbmayormaynotbeincludedwith34805. +Add-oncode;listinadditiontoprimaryprocedure PleasecontactourReimbursementteamat877-347-9662foranyquestions. Thesesuggestionsdonotreplaceseekingcodingadvicefromthepayerand/oryourcodingstaff. Theproviderofservicesisultimatelyresponsibleforcorrectcoding.

PRINCIPAL DIAGNOSIS

I71.4 - Abdominal aortic aneurysm without rupture

SECONDARY DIAGNOSIS

Extensions

Endurant® II AUI

34805: AUI graft

Endurant® IIs Stent GraftEndurant® II Abdominal Stent Graft

34802: Bifurcated graftand docking limb

34803: Bifurcated graft and docking limbs

34825/34826:Aortic Extension,Iliac Extensions Placement of proximalor distal extensions, initial vessel/each additional vessel.

CPT®isatrademarkoftheAmericanMedicalAssociation.10168446DOCRev1B©Medtronic2016.Allrightsreserved.PrintedinUSA.12/15

www.medtronic.comMedtronic3576 Unocal PlaceSanta Rosa, CA 95403USATel: 707.525.0111

Product ServicesTel: 888.283.7868Fax: 800.838.3103Reimbursement InformationTelephone: 877.347.9662www.medtronic.com/cvreimbursement

CPT® is a trademark of the American Medical Association. 10168446DOC Rev 1B © Medtronic 2016. All rights reserved. Printed in USA. 12/15

Endurant® II/Endurant® IIs Stent Graft System IndicationsTheEndurant®II/Endurant®IIsbifurcatedstentgraftisindicatedfortheendovasculartreatmentofinfrarenalabdominalaorticoraorto-iliacaneurysms.TheEndurantIIaorto-uni-iliac(AUI)stentgraftisindicatedfortheendovasculartreatmentofinfrarenalabdominalaorticoraortoiliacaneurysmsinpatientswhoseanatomydoesnotallowtheuseofabifurcatedstentgraft.TheEndurantII/EndurantIIsstentgraftsystemisindicatedforuseinpatientswiththe followingcharacteristics:

• Adequateiliac/femoralaccessthatiscompatiblewithvascularaccesstechniques,devicesand/oraccessories

• Proximalnecklengthof≥10mm • Infrarenalneckangulationof≤60° • Aorticneckdiameterswitharangeof19to32mm • Distalfixationlength(s)of≥15mm • Iliacdiameterswitharangeof8to25mm • Morphologysuitableforaneurysmrepair

ContraindicationsTheEndurantII/EndurantIIsStentGraftSystemiscontraindicatedin: • Patientswhohaveaconditionthatthreatenstoinfectthegraft. • Patientswithknownsensitivitiesorallergiestothedevicematerials.

Warnings and Precautions • Thelong-termsafetyandeffectivenessoftheEndurantII/EndurantIIsStent

GraftSystemhasnotbeenestablished.Allpatientsshouldbeadvisedthatendovasculartreatmentrequireslifelong,regularfollow-uptoassessthehealthandtheperformanceoftheimplantedendovascularstentgraft.Patientswithspecificclinicalfindings(e.g.,endoleaks,enlarginganeurysmsorchangesinthestructureorpositionoftheendovasculargraft)shouldreceiveenhancedfollow-up.Specificfollow-upguidelinesaredescribedintheInstructions for Use.

• Patientsexperiencingreducedbloodflowthroughthegraftlimb,aneurysmexpansion,andpersistentendoleaksmayberequiredtoundergosecondaryinterventionsorsurgicalprocedures.

• TheEndurantII/EndurantIIsStentGraftSystemisnotrecommendedinpatientsunabletoundergoorwhowillnotbecompliantwiththenecessarypreoperativeandpostoperativeimagingandimplantationstudiesasdescribedin the Instructions for Use.

• Renalcomplicationsmayoccur:1)Fromanexcessuseofcontrastagents.2)Asaresultofembolioramisplacedstentgraft.Theradiopaquemarkeralongtheedgeofthestentgraftshouldbealignedimmediatelybelowthelower-mostrenalarterialorigin.

• Studiesindicatethatthedangerofmicro-embolizationincreaseswithincreaseddurationoftheprocedure.

• ThesafetyandeffectivenessoftheEndurantII/EndurantIIsStentGraftSystemhasnotbeenevaluatedinsomepatientpopulations.PleaserefertotheproductInstructions for Usefordetails.

MRI Safety and Compatibility Non-clinicaltestinghasdemonstratedthattheEndurantII/EndurantIIsStentGraftisMRConditional.Itcanbescannedsafelyinboth1.5T&3.0TMRsystemsundercertainconditionsasdescribedintheproductInstructions for Use.ForadditionalinformationregardingMRIpleaserefertotheproductInstructions for Use.

Adverse Events Potentialadverseeventsinclude(arrangedinalphabeticalorder):amputation;anestheticcomplicationsandsubsequentattendantproblems(e.g.,aspiration),aneurysmenlargement;aneurysmruptureanddeath;aorticdamage,includingperforation,dissection,bleeding,ruptureanddeath;arterialorvenousthrombosisand/orpseudoaneurysm;arteriovenousfistula;bleeding,hematomaorcoagulopathy;bowelcomplications(e.g.,ileus,transientischemia,infarction,necrosis);cardiaccomplicationsandsubsequentattendantproblems(e.g.,arrhythmia,myocardialinfarction,congestiveheartfailure,hypotension,hypertension);claudication(e.g.,buttock,lowerlimb);death;edema;embolization(microandmacro)withtransientorpermanentischemiaorinfarction;endoleak;feverandlocalizedinflammation;genitourinarycomplicationsandsubsequentattendantproblems(e.g.,ischemia,erosion,femoral-femoralarterythrombosis,fistula,incontinence,hematuria,infection);hepaticfailure;impotence;infectionoftheaneurysm,deviceaccesssite,includingabscessformation,transientfeverandpain;lymphaticcomplicationsandsubsequentattendantproblems(e.g.,lymphfistula);neurologiclocalorsystemiccomplicationsandsubsequentattendantproblems(e.g.,confusion,stroke,transientischemicattack,paraplegia,paraparesis,paralysis);occlusionofdeviceornativevessel;pulmonarycomplicationsandsubsequentattendantproblems;renalcomplicationsandsubsequentattendantproblems(e.g.,arteryocclusion,contrasttoxicity,insufficiency,failure);stentgraft:impropercomponentplacement;incompletecomponentdeployment;componentmigration;suturebreak;occlusion;infection;stentfracture;grafttwistingand/orkinking;insertionandremovaldifficulties;graftmaterialwear;dilatation;erosion;punctureandperigraftflow;surgicalconversiontoopenrepair;vascularaccesssitecomplications,includinginfection,pain,hematoma,pseudoaneurysm,arteriovenousfistula,dissection;vascularspasmorvasculartrauma(e.g.,iliofemoralvesseldissection,bleeding,rupture,death);vesseldamage;woundcomplicationsandsubsequentattendantproblems(e.g.,dehiscence,infection,hematoma,seroma,cellulitis)

PleasereferenceproductInstructions for Useformoreinformationregardingindications,warnings,precautions,contraindicationsandadverseevents.

CAUTION:Federal(USA)lawrestrictsthisdevicetosalebyorontheorderof aphysician.

www.medtronic.comMedtronic3576 Unocal PlaceSanta Rosa, CA 95403USATel: 707.525.0111

Product ServicesTel: 888.283.7868Fax: 800.838.3103Reimbursement InformationTelephone: 877.347.9662www.medtronic.com/cvreimbursement