Coding for an aortic cuff and abdominal aortic aneurysm stent graft

Q.

Is an aortic cuff considered part of the placement of an abdominal aortic aneurysm stent graft, CPT^® code 34705, or should I add CPT code 34709 for the aortic cuff? 

A.

When assigning CPT code 34705, the “treatment zone” includes the aorta from the renal arteries through the common iliacs. So, if an aortic cuff is placed within that area it is included in CPT code 34705 and not separately coded as an extension. Only if it is placed (during the same session as the placement of the endograft itself) above the renal arteries would you assign CPT code 34709. 

The codes and full descriptions are: 

34705 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of 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)

34709 Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal 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)