Summary & Overview
CPT 0075T: Extracranial Vertebral Artery Stent Placement
CPT code 0075T represents an endovascular procedure to place a stent in an extracranial vertebral artery to treat stenosis or blockage; it also includes the imaging, radiological supervision, and interpretation needed to determine and support the intervention. This procedure is clinically important for patients at risk of posterior circulation ischemia and has implications for hospital-based vascular and interventional radiology services nationwide. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context and service settings, summaries of payer coverage patterns where available, and benchmarking and policy-related considerations relevant to reimbursement and utilization. The publication covers how this service is typically delivered (hospital outpatient or inpatient interventional suite), what the code bundles (procedure plus imaging and interpretation), and implications for billing and clinical documentation. Data not available in the input will be noted explicitly in sections that require payer-specific rates, taxonomies, diagnosis pairings, or utilization metrics.
Billing Code Overview
CPT code 0075T describes a percutaneous stent placement into an extracranial vertebral artery via an incision in the skin to treat stenosis or occlusion. The code includes imaging performed to determine the need for stenting along with radiological supervision and interpretation.
Service type: Endovascular stent placement for extracranial vertebral artery stenosis
Typical site of service: Hospital outpatient department or inpatient vascular/interventional suite, where endovascular procedures and fluoroscopic imaging are performed.
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with history of hypertension and hyperlipidemia presents with recurrent transient ischemic attacks characterized by brief episodes of vertigo and diplopia over 2 weeks. Noninvasive vascular imaging (CTA) demonstrates high-grade extracranial vertebral artery stenosis (proximal V1 segment) with correlating symptoms. The interventional neuroradiology team evaluates the patient and determines endovascular stent placement is indicated to restore luminal diameter and reduce recurrent posterior-circulation ischemia.
The clinical workflow: the patient is admitted to an endovascular suite or hybrid operating room for the procedure. Pre-procedure includes vascular access planning, informed consent, review of antiplatelet strategy, and baseline neurological assessment. Under conscious sedation or general anesthesia, percutaneous femoral or radial arterial access is obtained, diagnostic angiography performed to confirm lesion morphology and necessity for stent placement, then angioplasty and stent deployment in the extracranial vertebral artery are completed. Intra-procedural fluoroscopic imaging and radiological supervision/interpretation are performed throughout. Post-procedure, the patient is observed in a recovery unit or monitored bed for access-site complications, hemodynamic stability, and neurological status, with follow-up imaging as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation/radiology professional work separated from the technical component. |
51 | Multiple procedures | Use when multiple distinct procedures are performed during the same session and payer requires modifier reporting for multiple procedures. |
52 | Reduced services | Use if the stent procedure is started but not completed as planned and a reduced service is provided. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after anesthesia induction but before completion. |
62 | Two surgeons | Use when two surgeons with different specialties perform distinct portions of the case concurrently. |
66 | Surgical team | Use when a surgical team approach is employed and the payer requires the team modifier. |
78 | Unplanned return to OR (during postoperative period) | Use if the patient returns to the operating room for a related procedure for complications within the global period. |
80 | Assistant surgeon | Use when a surgical assistant (credentialed) provides assistance and reporting is required. |
81 | Minimum assistant surgeon | Use when a minimum assistant is used and payer accepts this modifier. |
82 | Assistant surgeon (when qualified resident not available) | Use when an assistant surgeon is necessary and a qualified resident is not available. |
AD | Regional block performed by surgeon | Use when the primary surgeon personally performs a qualifying regional block for anesthesia as part of the procedure. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant-at-surgery | Use when these nonphysician clinicians function as assistant-at-surgery and payers allow modifier AS. |
LT | Left side | Use to indicate the procedure was performed on the left vertebral artery. |
RT | Right side | Use to indicate the procedure was performed on the right vertebral artery. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2086P0200X | Vascular Surgery | Vascular surgeons commonly perform extracranial vertebral artery stenting. |
| 207T00000X | Interventional Neuroradiology | Interventional neuroradiologists frequently perform diagnostic angiography and vertebral artery stenting. |
| 2084P0800X | Interventional Cardiology | Some interventional cardiologists with endovascular training perform carotid and vertebral interventions. |
| 207RH0000X | Diagnostic Radiology | Diagnostic radiologists provide radiological supervision and interpretation of intra-procedural imaging. |
| 363A00000X | Anesthesiology | Anesthesiologists provide sedation or general anesthesia for the procedure when indicated. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I65.29 | Occlusion and stenosis of other cerebral arteries, not resulting in cerebral infarction | Represents extracranial vertebral artery stenosis causing symptomatic cerebral ischemia without documented infarction; common indication for stent placement. |
I66.2 | Occlusion and stenosis of vertebral artery | Directly describes vertebral artery occlusion/stenosis and is a primary diagnostic reason for stenting. |
I63.89 | Other cerebral infarction | Used when the patient has had a cerebral infarction related to vertebral artery disease; may justify intervention to prevent recurrence. |
G45.9 | Transient ischemic attack, unspecified | TIA due to posterior circulation ischemia is a frequent presenting scenario leading to evaluation for vertebral stenting. |
I74.8 | Embolism and thrombosis of other specified arteries | May be used when embolic phenomena in vertebral distribution prompt revascularization efforts. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0075T | Stent placement in extracranial vertebral artery via percutaneous incision; includes imaging for determination of need for stenting and radiological supervision/interpretation. | Primary procedure code describing stent placement and included diagnostic imaging and R/S&I. |
36215 | Selective catheter placement, vertebral, with angiography of the head/neck, unilateral, radiological supervision and interpretation. | Often performed before stent placement to define lesion anatomy; may be billed when separate diagnostic angiography is performed and not included in primary reporting. |
37226 | Transcatheter placement of intravascular stent(s), open or percutaneous, vertebral artery, initial vessel. | Alternative or related stent placement code used in some payer policies; useful when reporting transcatheter stenting in vertebral circulation depending on coding guidance. |
75635 | Angiography, extra-cranial vessels (e.g., neck), bilateral (eg, carotid, vertebral) radiological supervision and interpretation, including initial images and documentation. | May be reported for comprehensive noninvasive or catheter-based diagnostic imaging of extracranial cerebrovascular circulation performed in the same episode. |
92928 | Percutaneous transcatheter placement of intracoronary stent(s); single major coronary artery or branch. | Not directly for vertebral artery but included here to illustrate stent placement coding conventions; rarely used in cerebrovascular procedures and generally not billed for vertebral stents. |