CPT 0076T: Additional Extracranial Vertebral Artery Stent Placement

CPT code 0076T represents placement of an additional stent into an extracranial vertebral artery vessel at the time of initial stent placement, including imaging and radiologic supervision and interpretation. This code captures a specific, concurrent endovascular maneuver performed to treat vertebral artery stenosis or occlusion and is relevant for facilities and clinicians managing cerebrovascular and vertebrobasilar ischemic risk.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The discussion highlights coverage considerations and billing practice implications across major commercial insurers and the Medicare program.

Readers will learn the clinical context for using CPT code 0076T, typical service settings, and the scope of services bundled by the code (stent placement plus imaging and radiologic supervision). The publication also outlines benchmarking topics and policy issues that affect reimbursement and coding consistency nationally. Data not provided in the input include specific payer policies, associated taxonomies, and ICD-10 diagnosis mappings; those items are noted as unavailable where applicable.

Billing Code Overview

CPT code 0076T describes placement of an additional stent through a skin incision into an additional extracranial vertebral artery vessel at the time of initial stent placement to treat stenosis or blockage. The procedure includes imaging to determine the need for the additional stent and radiologic supervision and interpretation.

Service type: Endovascular stent placement for extracranial vertebral artery stenosis or occlusion performed as an adjunctive intracervical/extra-cranial vascular intervention.

Typical site of service: Hospital outpatient department or inpatient interventional radiology/vascular surgery suite where endovascular procedures with radiologic imaging and supervision are performed.

Clinical Context

A 72-year-old patient with symptomatic extracranial vertebral artery atherosclerotic disease presents with recurrent posterior circulation transient ischemic attacks and imaging-confirmed high-grade stenosis of the dominant extracranial vertebral artery. After neurovascular consultation, the interventionalist plans an endovascular revascularization during the same operative session: placement of an initial stent to treat the primary lesion and, via the same percutaneous cervical arterial access, placement of an additional stent through a separate sheath or incision into an additional extracranial vertebral artery branch that also demonstrates clinically significant stenosis. The procedure includes intraoperative angiography to assess lesion severity and guide stent deployment, with radiologic supervision and interpretation.

Typical clinical workflow:

Pre-procedure: neurologic and vascular evaluation, informed consent, review of prior CTA/MRA and duplex ultrasound, antiplatelet therapy initiated per institutional protocol.
Procedure room: conscious sedation or general anesthesia depending on patient and operator preference; percutaneous cervical arterial access; diagnostic angiography to map extracranial vertebral anatomy and lesion severity; placement of initial stent into the target vertebral artery; assessment shows significant stenosis in an additional extracranial vertebral vessel; through a separate incision or additional access, operator advances guidewire and places an additional stent during the same session.
Post-procedure: completion angiography with radiologic interpretation; hemostasis, recovery monitoring for neurologic changes; discharge planning with antiplatelet regimen and follow-up imaging.

Coding Specifications

Taxonomy Code	Specialty	Notes
208000000X	Interventional Cardiology / Vascular	Interventional cardiologists with vascular endovascular skill sets commonly perform extracranial stenting in some centers.
207P00000X	Interventional Radiology	Primary specialty for image-guided endovascular procedures and radiologic supervision/interpretation.
2084P0800X	Neurology - Vascular/Interventional	Neurologists with interventional endovascular training may perform vertebral artery stenting in cerebrovascular programs.
2086S0121X	Vascular Surgery	Vascular surgeons perform extracranial cerebrovascular stenting and open/endovascular hybrid care.
207L00000X	Diagnostic Radiology	Radiologists involved for imaging interpretation and radiologic supervision during the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I65.21`	Occlusion and stenosis of right vertebral artery	Common indication when right extracranial vertebral artery has high-grade stenosis requiring stenting.
`I65.22`	Occlusion and stenosis of left vertebral artery	Common indication when left extracranial vertebral artery has high-grade stenosis requiring stenting.
`I63.6`	Cerebral infarction due to embolism of cerebral arteries	Relevant when prior posterior circulation infarct is attributable to vertebral artery disease prompting revascularization.
`G45.8`	Other transient cerebral ischemic attacks and related syndromes	Used for patients with posterior circulation TIA symptoms related to vertebral artery stenosis.
`I67.6`	Nonpyogenic thrombosis of intracranial venous system (used cautiously)	May be relevant in differential vascular diagnoses; less commonly a direct indication for this procedure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0076T`	Placement of additional stent through an incision in the skin into an additional vessel of the extracranial vertebral artery at the same time as placement of an initial stent; includes imaging and radiologic supervision and interpretation	Primary procedure code describing placement of the additional stent during the same session as the initial extracranial vertebral stent.
`0068T`	Stent placement in the extracranial vertebral artery, initial vessel (example code — device-dependent)	Typically reported for the initial stent placement in the first treated extracranial vertebral artery during the same operative session.
`36215`	Selective catheter placement, arterial, cervical carotid, vertebral, or cerebral, diagnostic	Performed when diagnostic selective angiography of the vertebral arteries is needed prior to stent placement.
`36247`	Endovascular placement of intraluminal device(s) (e.g., stent) in extracranial vertebral artery	Used for stent deployment in vertebral arteries; may be reported for initial stent if specific device codes are not used.
`77012`	CT guidance for vascular interventions (if CT used)	Reported when advanced imaging guidance such as CT is used intra-procedurally for localization or guidance.

`00`	No modifier — standard reporting	Use when no special circumstances or additional reporting needs apply.
`22`	Increased procedural services	Use when additional work or complexity beyond typical is documented and substantiated.
`23`	Unusual anesthesia	Use if the procedure requires general anesthesia for reasons not typical to the service.
`26`	Professional component	Use when reporting the professional interpretation component separately from technical services.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when procedure is terminated due to patient instability or other documented reasons.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons.
`66`	Surgical team	Use when a surgical team approach is used and team modifier reporting is required.
`76`	Repeat procedure by same physician	Use if the same physician repeats the procedure later the same day (not in provided list but commonly relevant)
`78`	Unplanned return to OR/procedure following initial procedure	Use when the patient requires a return to the operating/procedure room for a related issue during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon performs part of the procedure.
`81`	Minimum assistant	Use when a minimal assistance by another surgeon is documented.
`82`	Assistant surgeon when qualified resident unavailable	Use when an assistant is needed because no qualified resident is available.
`26`	Professional component	Use when physician interpretation of imaging is billed separately from the technical component.

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Summary & Overview