August 2017 Q & A

Question: Repair of EVAR with Deployment of 2 Gore Excluder Limbs

This patient developed a type III endoleak due to component separation of the left iliac limb from a prior EVAR. To repair this, our physicians first used an Excluder limb across both graft defects followed by a second Excluder limb in the patient's iliac, to bridge the separation of components. I would normally code this with 34825, 75953.

However, I am not sure how to code for a second graft in this case or if I can code for it at all because I am not positive that the second graft is considered a separate vessel and qualifies for the 34826. There is no mention of it being placed in either the external or internal iliac.

Answer:

This is one endoleak at the separation of the left limb so would only code 34825, 75953 along with the appropriate catheter placement.