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Member and Recipient Service Line: 1-877-685-2415

Provider Support Service Line: 1-855-250-1539

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12465 Results

Injection procedure for extremity venography (including introduction of needle or intracatheter)

Service Code
36005 (CPT) Injection procedure for extremity venography (including introduction of needle or intracatheter)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Introduction of catheter, superior or inferior vena cava

Service Code
36010 (CPT) Introduction of catheter, superior or inferior vena cava
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)

Service Code
36011 (CPT) Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)

Service Code
36012 (CPT) Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Introduction of catheter, right heart or main pulmonary artery

Service Code
36013 (CPT) Introduction of catheter, right heart or main pulmonary artery
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, left or right pulmonary artery

Service Code
36014 (CPT) Selective catheter placement, left or right pulmonary artery
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, segmental or subsegmental pulmonary artery

Service Code
36015 (CPT) Selective catheter placement, segmental or subsegmental pulmonary artery
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Introduction of needle or intracatheter, carotid or vertebral artery

Service Code
36100 (CPT) Introduction of needle or intracatheter, carotid or vertebral artery
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Endovascular Repair of Aortic Aneurysm

Service Code
36140 (CPT) Introduction of needle or intracatheter, upper or lower extremity artery
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Introduction of needle or intracatheter, aortic, translumbar

Service Code
36160 (CPT) Introduction of needle or intracatheter, aortic, translumbar
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Endovascular Repair of Aortic Aneurysm

Service Code
36200 (CPT) Introduction of catheter, aorta
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Endovascular Repair of Aortic Aneurysm

Service Code
36215 (CPT) Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Endovascular Repair of Aortic Aneurysm

Service Code
36216 (CPT) Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Endovascular Repair of Aortic Aneurysm

Service Code
36217 (CPT) Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Endovascular Repair of Aortic Aneurysm

Service Code
36218 (CPT) Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Aortic aneurysms can develop anywhere along the length of the aorta, but three-fourths of aneurysms are located in the abdominal aorta. Thoracic aortic aneurysms, including those that extend from the descending thoracic aorta into the upper abdomen, account for one-fourth of aortic aneurysms.

Endovascular stent grafting of the vascular system has emerged as a therapeutic modality for aortic aneurysms. Their safety and efficacy has been explored in the treatment of thoracic aortic aneurysms, abdominal aortic aneurysms, and peripheral arterial aneurysms.

Endovascular graft repair is performed under general, spinal or regional anesthesia. During the procedure, a prosthetic endograft is introduced with radiographic guidance through the femoral artery, iliac artery or the abdominal aorta. The device is advanced to the aneurysm site, deployed, and attached to the normal aorta with a self-expandable stent system. While both thoracic and abdominal aneurysms can be surgically repaired using stents and grafts, these open procedures are associated with considerable morbidity and mortality. Endovascular repair was developed to provide a minimally invasive approach, using a catheter inserted through a small groin incision to place the stent/graft across the aneurysm site. Patients requiring aortic aneurysm artery repair often have very significant co-morbid conditions including cardiac, pulmonary, and renal disease or insufficiency, and the comorbidities significantly increase the risk for major perioperative complications following open surgical repair.

A thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder involving a structural weakness of the aortic wall. Progressive arterial dilation and possible rupture may occur.

Standard treatment for thoracic aortic aneurysms is an open surgical resection and replacement of the diseased aorta with a graft.

An abdominal aortic aneurysm (AAA) is usually asymptomatic until it expands or ruptures.

Presence of a pulsatile abdominal mass is virtually diagnostic but is found in less than half of cases. Rupture is uncommon if aneurysms are less than 5 cm in diameter, but ruptures are dramatically more common for aneurysms greater than 6 cm in diameter. Without prompt intervention, ruptured aneurysms are often fatal.

Endovascular stent grafting for the repair of descending thoracic aorta (DTA) and AAA is an option for treatment of aneurysms and may be covered for patients who meet the required criteria.

Authorization Guidelines

See the Turning Point site for specific requirements

Reauthorization Guidelines

See the Turning Point site for specific requirements

Limits

Medicaid only covers one procedure per date of service

Exclusions

Do not report 33881, 33883 when extension placement converts repair to cover left subclavian origin. Use only 33880.

Do not report 33886 in conjunction with 33880, 33881.

Report 33886 once, regardless of number of modules deployed.

Do not report 33889 in conjunction with 35694.

Do not report 33891 in conjunction with 35509, 35601.

Report CPT codes 34812, 34820, 34833, 34844, as appropriate.

Do not report 34833 in addition to 34820.

Place of Service

Inpatient hospital, Outpatient hospital, Office

Additional Service Specifics

Codes 33880 through 33891 represent a family of procedures to report placement of an endovascular graft for repair of the aorta. These codes include all device introduction, manipulation, positioning and deployment. All balloon angioplasty and/or stent deployment within the target treatment zone for the endoprosthesis, either before or after endograft deployment, are not reported separately.

Other Information

The following procedure codes, when applicable, are reported separately: 34812, 34820, 34833 through 34834, 35226, 35286, 36140, 36200 through 36218, 36245 through 36248

How to Submit

Please submit your request to Turning Point

Resources

Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the ce

Service Code
36221 (CPT) Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the ce
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the c

Service Code
36222 (CPT) Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the c
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the e

Service Code
36223 (CPT) Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the e
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and ce

Service Code
36224 (CPT) Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and ce
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when per

Service Code
36225 (CPT) Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when per
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

If your request is for OUTPATIENT services, please see the Turning Point site for specific requirements. If your request is for INPATIENT services, If your request is for INPATIENT services, please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.

Conditional Requirements

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.

How to Submit

If your request is for OUTPATIENT services, please submit the request to Turning Point. If your request is for INPATIENT services, please submit the request to Trillium.