Endovascular Repair of Abdominal Aortic Aneurysm (EVAR)codingstrategies.com/sites/default/files/2019...
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Endovascular Repair of Abdominal Aortic Aneurysm (EVAR) Coverage, Coding and Reimbursement Overview — Physician 2019 Edition — All Reimbursement Amounts are Listed at National Unadjusted Medicare Rates and Do Not Include the 2% Sequestration Reduction Physician rates effective January 1, 2019 through December 31, 2019 PROCEDURE A Total Professional/ Facility RVUs B Global Surgery Indicator C Fee Schedule B 34701 Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube 35.85 090 $1,292 endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) 34702 for rupture including temporary aortic and/or iliac balloon occlusion, when 53.54 090 $1,930 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) 34703 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an 40.36 090 $1,455 aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) 34704 for rupture including temporary aortic and/or iliac balloon occlusion, when 67.26 090 $2,424 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) 34705 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of 44.39 090 $1,600 an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) 34706 for rupture including temporary aortic and/or iliac balloon occlusion, when 66.88 090 $2,410 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved. B. Rates are from the CY 2019 Physician Fee Schedule Final Rule, CMS-1693-F, Centers for Medicare and Medicaid Services. Conversion Factor = $36.0391. C. Status Indicators: 090 - global postoperative period is 90 days from the date of surgery. REIMBURSEMENT CPT® Code A Description PHYSICIAN OVERVIEW
Transcript of Endovascular Repair of Abdominal Aortic Aneurysm (EVAR)codingstrategies.com/sites/default/files/2019...
Endovascular Repair of Abdominal Aortic Aneurysm (EVAR) Coverage, Coding and Reimbursement Overview — Physician2019 Edition — All Reimbursement Amounts are Listed at National Unadjusted Medicare Rates and Do Not Include the 2% Sequestration Reduction
Physician rates effective January 1, 2019 through December 31, 2019
PROCEDUREA Total
Professional/ Facility RVUsB
Global Surgery
IndicatorC
Fee ScheduleB
34701 Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube 35.85 090 $1,292endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level ofthe renal arteries to the aortic bifurcation; for other than rupture (eg, foraneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34702 for rupture including temporary aortic and/or iliac balloon occlusion, when 53.54 090 $1,930 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34703 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an 40.36 090 $1,455aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of therenal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34704 for rupture including temporary aortic and/or iliac balloon occlusion, when 67.26 090 $2,424 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34705 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of 44.39 090 $1,600an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision andinterpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34706 for rupture including temporary aortic and/or iliac balloon occlusion, when 66.88 090 $2,410 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Rates are from the CY 2019 Physician Fee Schedule Final Rule, CMS-1693-F, Centers for Medicare and Medicaid Services. Conversion Factor = $36.0391.C. Status Indicators: 090 - global postoperative period is 90 days from the date of surgery.
REIMBURSEMENT
CPT® CodeA Description
PHYSICIAN OVERVIEW
Physician rates effective January 1, 2019 through December 31, 2019
PROCEDUREA
Total Professional/
Facility RVUsB
Global Surgery
IndicatorC
Fee ScheduleB
34707 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft 33.44 090 $1,205including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to theiliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation)
34708 for rupture including temporary aortic and/or iliac balloon occlusion, when 53.68 090 $1,935 performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
+34709 Placement of extension prosthesis(es) distal to the common iliac artery(ies) or 9.38 ZZZ $338proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure)
34710 Delayed placement of distal or proximal extension prosthesis for endovascular 23.24 090 $838repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection,endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; initial vessel treated
+34711 each additional vessel treated (List separately in addition to code for primary 8.66 ZZZ $312 procedure)
34712 Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, 19.85 090 $715screw, tack) and all associated radiological supervision and interpretation
+34713 Percutaneous access and closure of femoral artery for delivery of endograft 3.73 ZZZ $134through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in addition to code for primary procedure)
+34714 Open femoral artery exposure with creation of conduit for delivery of endovascular 7.84 ZZZ $283prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Rates are from the CY 2019 Physician Fee Schedule Final Rule, CMS-1693-F, Centers for Medicare and Medicaid Services. Conversion Factor = $36.0391.C. Status Indicators: 090 - global postoperative period is 90 days from the date of surgery; ZZZ - add-on codes that must be billed with a primary service, and therefore the global period from the primary procedure code is applied to the add-on code.
REIMBURSEMENT
CPT® CodeA Description
PHYSICIAN OVERVIEW
Physician rates effective January 1, 2019 through December 31, 2019
PROCEDUREA
Total Professional/
Facility RVUsB
Global Surgery
IndicatorC
Fee ScheduleB
+34715 Open axillary/subclavian artery exposure for delivery of endovascular prosthesis 8.79 ZZZ $317by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure)
+34716 Open axillary/subclavian artery exposure with creation of conduit for delivery of 10.87 ZZZ $392endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure)
+34808 Endovascular placement of iliac artery occlusion device (List separately in addition 6.11 ZZZ $220to code for primary procedure)
+34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin 6.00 ZZZ $216incision, unilateral (List separately in addition to code for primary procedure)
+34813 Placement of femoral-femoral prosthetic graft during endovascular aortic 6.85 ZZZ $247aneurysm repair (List separately in addition to code for primary procedure)
+34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion 10.09 ZZZ $364during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)
34830 Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated 50.80 090 $1,831arterial trauma, following unsuccessful endovascular repair; tube prosthesis
34831 aorto-bi-iliac prosthesis 55.99 090 $2,018
34832 aorto-bifemoral prosthesis 53.96 090 $1,945
+34833 Open iliac artery exposure with creation of conduit for delivery of endovascular 11.72 ZZZ $422prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primaryprocedure)
+34834 Open brachial artery exposure for delivery of endovascular prosthesis, unilateral 3.75 ZZZ $135(List separately in addition to code for primary procedure)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Rates are from the CY 2019 Physician Fee Schedule Final Rule, CMS-1693-F, Centers for Medicare and Medicaid Services. Conversion Factor = $36.0391.C. Status Indicators: 090 - global postoperative period is 90 days from the date of surgery; ZZZ - add-on codes that must be billed with a primary service, and therefore the global period from the primary procedure code is applied to the add-on code.
REIMBURSEMENT
CPT® CodeA Description
PHYSICIAN OVERVIEW
Physician rates effective January 1, 2019 through December 31, 2019
PROCEDUREA
Total Professional/
Facility RVUsB
Global Surgery
IndicatorC
Fee ScheduleB
0254T Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, ---- YYY Carrier Pricedarteriovenous malformation, trauma, dissection) using bifurcated endograft from the common iliac artery into both the external and internal iliac artery, including all selective and/or nonselective catheterization(s) required for device placement and all associated radiological supervision and interpretation, unilateral
ANCILLARY PROCEDURES+37252 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or 35.78 ZZZ $1,289
therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primaryprocedure)
+37253 5.60 ZZZ $202 primary procedure)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Rates are from the CY 2019 Physician Fee Schedule Final Rule, CMS-1693-F, Centers for Medicare and Medicaid Services. Conversion Factor = $36.0391.C. Status Indicators: YYY - contractor -priced codes, for which MACs determine the global period; ZZZ - add-on codes that must be billed with a primary service, and therefore the global period from the primary procedure code is applied to the add-on code.
REIMBURSEMENT
CPT® CodeA Description
each additional noncoronary vessel (List separately in addition to code for
PHYSICIAN OVERVIEW
salbright
Typewritten Text
REV011719PT
