Effective October 1, 2011, code 39.77, Temporary (partial) therapeutic endovascular occlusion of vessel, was created to classify procedures in which the vessel is partially occluded via an endovascular device. Currently, the procedure has been approved for an endovascular balloon catheter to partially occlude the abdominal aorta to treat patients with cerebral ischemia. Prior to this change, there was no unique or predecessor code to describe this procedure. This procedure is different from existing occlusion procedure codes which completely occlude the vessel or permanently occlude the vessel.
Code 39.78, Endovascular implantation of branching or fenestrated graft(s) in aorta, has been created to uniquely recognize new technology being developed to offer an endovascular repair option to patients who are not anatomical candidates for standard commercially available endovascular devices available for repairs of abdominal aortic aneurysms (AAA). This includes patients with short or angulated necks, aneurysmal extension into either internal iliac artery, or complex aneurysmal involvement of the juxtarenal, paravisceral, and thoracoabdominal aorta.
The branching or fenestrated endograft, is a tubular, fabric graft with supporting metal stents that features custom-positioned holes (fenestrations) that ensure proper blood flow through the aorta and to the kidneys and nearby organs. Each fenestrated graft is customized for each individual aneurysm as it is important that all the holes in the graft fit the precise anatomy of each aneurysm. These grafts were designed to extend the proximal sealing zone from the infrarenal segment to the juxta and suprarenal aorta, thereby circumventing the limitation of short or absent aortic necks.
In addition, the title of code 39.71 has been revised to "Endovascular implantation of other graft in abdominal aorta" and will be used to describe the standard endovascular repair of abdominal aortic aneurysms.
39.7 Endovascular procedures on vessel(s) Revise exclusion term Excludes: angioplasty
or atherectomyof other noncoronary vessel(s) (39.50) Add exclusion term atherectomy of other noncoronary vessel(s) (17.56) Add exclusion term temporary therapeutic partial occlusion of vessel (39.77) Revise code title 39.71 Endovascular implantation of other graft in abdominal aorta Add exclusion term Excludes: endovascular implantation of branching or fenestrated graft in aorta (39.78) Revise code title 39.72 Endovascular (total) embolization or occlusion of head and neck vessels Add inclusion term Coil-retention stent Add inclusion term Embolization stent New code 39.77 Temporary (partial) therapeutic endovascular occlusion of vessel Includes that of aorta That by balloon catheter Code also: any diagnostic arteriogram (88.40-88.49) Excludes: any endovascular head or neck vessel procedure (39.72, 39.74-39.76) diagnostic procedures on blood vessels (38.21-38.29) permanent endovascular procedure (39.79) New code 39.78 Endovascular implantation of branching or fenestrated graft(s) in aorta 39.79 Other endovascular procedures on other vessels Add exclusion term Excludes: uterine artery embolization with coils (68.24)