TEVAR
TEVAR Criteria
Question: What is the main criteria used to determine the primary procedure code for the TEVAR procedure?
Answer: Based on the code descriptions, the main criteria used to determine the primary procedure code for the TEVAR procedure is whether the endoprosthesis is covering the subclavian artery origin or not.
TEVAR Extension Prosthesis
Question: In a TEVAR procedure, when an extension prosthesis placement converts the TEVAR to coverage of the left subclavian origin, what procedure code should be reported?
Answer: Per CPT® guidelines, only code 33880 should reported in this case:
33880 – Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin
TEVAR with Thoracic Branch Endoprosthesis (TBE)
Question: What is the thoracic branch endoprosthesis (TBE) and how is it used?
Answer: The TBE endoprosthesis is comprised of three components: the aortic component, which is implanted into the descending thoracic aorta; the side branch component, which is implanted in the left subclavian artery; and the optional aortic extension/cuff, which can be implanted proximally into the aortic arch or distally into the descending thoracic aorta to help seal the aortic component. Collectively, this device is used for patients at high risk for debranching subclavian procedures as determined by the performing physician.
TEVAR with Thoracic Branch Endoprosthesis (TBE) Procedure for Physician
Question: How is the TEVAR with TBE procedure reported for physician services?
Answer: For physician reporting, there is no listed CPT® code for the TEVAR with TBE procedure, so it would be reported with an unlisted CPT® procedure code.
TEVAR with Thoracic Branch Endoprosthesis (TBE) Procedure for Inpatient Hospital
Question: How is the TEVAR with TBE procedure reported for hospital inpatient services?
Answer: For inpatient hospital reporting, two ICD-10-PCS codes should be reported for TEVAR with TBE:
02VW3DZ – Restriction of thoracic aorta, descending with intraluminal device, percutaneous approach
02VX3EZ – Restriction of thoracic aorta, descending with branched or fenestrated intraluminal device, one or two arteries, percutaneous approach
Radiological Supervision and Interpretation (R S&I)
Question: Can radiological supervision and interpretation services be separately reported for TEVAR?
Answer: For each TEVAR code, there is a separately reportable radiological supervision and interpretation code which is cross referenced in the CPT® manual:
33880, 75956 – TEVAR involving coverage of left subclavian artery origin
33881, 75957 – TEVAR not involving coverage of left subclavian artery origin
33883, 75958 – Placement of proximal extension prosthesis for TEVAR, initial extension
33884, 75958 – Placement of proximal extension prosthesis for TEVAR, each add’l proximal extension
33886, 75959 – Placement of distal extension prosthesis, delayed after TEVAR
