Q: Is a chronic contained rupture considered a ruptured aneurysm?
A: CPT defines rupture as an acute hemorrhage related to the aneurysm. Patients with rupture are most likely hemodynamically unstable and require emergent treatment. A chronic contained rupture or pseudoaneurysm does not meet this criterion. Use the “no rupture” code to report aneurysm repair for a chronic contained aneurysm. This is an important distinction because the rupture codes have higher RVUs.
Q: Can IVUS be coded with EVAR procedures?
A: Yes, intravascular ultrasound (IVUS) is separately reportable with all endovascular aneurysm repair codes, per CPT code instruction.
Q: Does modifier 62 apply to these codes?
A: EVAR procedures can be performed by teams of physicians including a radiologist and vascular surgeon, so modifier 62 is appropriate. These codes have a co-surgery indicator of 2 and may be paid as long as the two-specialty requirement is met.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.