Summary & Overview

CPT 0995T: Open Intra‑Aortic Drug Delivery for Abdominal Aortic Aneurysm

CPT code 0995T represents an open surgical approach to deliver drug therapy inside the aorta to treat an abdominal aortic aneurysm, incorporating intraoperative imaging, aortic roadmapping, balloon occlusion, and radiology supervision and interpretation. This procedural code captures a complex hybrid surgical–endovascular intervention that combines open vascular access with image-guided drug delivery. Nationally, the code is relevant for hospitals and multidisciplinary vascular teams managing complex aneurysm cases that may not be amenable to standard endovascular repair.

Key payers included in the discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, the typical hospital-based site of service, and what to expect in terms of coding context. The publication outlines benchmarks and policy implications relevant to payer coverage and hospital billing practice, summarizes clinical context for when this service is used in aneurysm care, and highlights areas where stakeholders commonly seek clarification (coding bundling, documentation of imaging and supervision, and facility versus professional reporting). Data not available in the input is clearly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0995TCPTaortic aneurysmintra-aortic drug deliveryopen surgeryintraoperative imagingvascular surgeryinterventional radiology

Billing Code Overview

CPT code 0995T describes an open surgical procedure to deliver drug therapy directly into the aorta for treatment of an abdominal aortic aneurysm. The service includes intraoperative imaging and roadmapping of the aorta, balloon occlusion to control blood flow during the infusion, and radiology supervision and interpretation as part of the procedure.

Service type: Open surgical intra-aortic drug delivery with intraoperative imaging and vascular access management
Typical site of service: Hospital operating room or hybrid operating room with interventional radiology support

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a 5.6 cm infrarenal abdominal aortic aneurysm (AAA) is scheduled for open surgical delivery of intra-aortic drug therapy to promote thrombosis and facilitate aneurysm repair. The patient has hypertension and peripheral vascular disease; preoperative imaging (CT angiography) confirmed aneurysm morphology suitable for direct aortic access. In the operating room under general anesthesia, the vascular surgery team performs an open abdominal approach to expose the aorta, places intra-aortic catheters under fluoroscopic guidance, obtains roadmapping images, inflates an occlusion balloon as needed to control inflow, and administers the therapeutic agent directly into the aneurysm sac while the radiology team provides supervision and interpretation of intraoperative imaging.

Service Type: Open surgical intra-aortic drug delivery with intraoperative imaging and radiology oversight.
Typical Site of Service: Hospital operating room, hybrid operating suite, or vascular surgery suite with fluoroscopic capability.
Clinical workflow highlights:
Preoperative evaluation with imaging (CT angiography) and anesthesia assessment.
Open surgical exposure of the abdominal aorta by the vascular surgeon.
Intraoperative vascular access and catheter positioning using fluoroscopy; acquisition of roadmap images.
Balloon occlusion deployed as indicated to limit blood flow during drug delivery.
Administration of intra-aortic drug therapy into the aneurysm sac.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when separately reporting the physician interpretation portion of radiologic services when billed distinct from technical services.
`50`	Bilateral procedure	Use if the procedure were reported bilaterally when applicable (not typical for midline aortic work but reserved for procedures with bilateral anatomic sites).
`51`	Multiple procedures	Use when multiple distinct procedures are performed during the same operative session and payer requires modifier for additional procedures.
`57`	Decision for surgery	Use when the E/M service on the day prior to surgery represents the decision for the surgical procedure (per payer rules).
`59`	Distinct procedural service	Use when a procedure or service is distinct and separate from other procedures performed on the same day, to indicate separate anatomic or procedural service.
`76`	Repeat procedure by same physician	Use when a procedure is repeated subsequent to the original procedure within the same day by the same physician.
`77`	Repeat procedure by another physician	Use when a procedure is repeated by a different physician on the same day.
`78`	Return to operating room for related procedure during postoperative period	Use when a patient returns to the OR for a related procedure during the global period.
`79`	Unrelated procedure or service by the same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`RT`	Right side	Use to denote right laterality when applicable to site-specific procedures.

Taxonomy Code	Specialty	Notes
`208K00000X`	Vascular Surgery	Primary surgical specialty performing open aortic procedures and intra-aortic interventions.
`207RC0000X`	Interventional Radiology	Provides intraoperative fluoroscopic guidance, roadmapping, and radiology supervision and interpretation.
`207L00000X`	Diagnostic Radiology	Radiologist performing imaging supervision and interpretation when not an interventional radiologist.
`2080P0005X`	General Surgery	May perform open abdominal aortic exposure and surgical access in some institutions.
`2084P0800X`	Critical Care Medicine	Involved in perioperative management for high-risk vascular surgery patients.

ICD-10 Code	Description	Clinical Relevance
`I71.4`	Abdominal aortic aneurysm, without rupture	Primary indication for intra-aortic drug therapy targeting the aneurysm sac.
`I71.3`	Abdominal aortic aneurysm, ruptured	Relevant when procedure is performed emergently for a ruptured AAA to control hemorrhage and deliver local therapy.
`I71.2`	Thoracoabdominal aortic aneurysm, without rupture	May be relevant for aneurysms extending into the abdomen where open intra-aortic delivery is indicated.
`I71.9`	Aortic aneurysm, unspecified site, without rupture	Used when specific aortic segment coding is not available but the aneurysm requires intra-aortic intervention.
`I72.3`	Aneurysm of other specified arteries	Occasionally relevant when aneurysmal disease involves adjacent arterial segments requiring intra-arterial therapy.

CPT Code	Description	Relationship to This Procedure
`34841`	Open repair of ruptured abdominal aortic aneurysm, with graft	Performed when definitive open aneurysm repair is required in the same operative setting or as subsequent definitive repair.
`34800`	Open repair of infrarenal abdominal aorta with graft	Commonly performed for definitive surgical correction of an AAA; may be performed before or after adjunctive intra-aortic therapy.
`36215`	Selective catheter placement, arterial system; each first order thoracic branch (e.g., renal, mesenteric)	May be used for selective catheterization during intra-arterial diagnostic or therapeutic maneuvers when additional catheter work is required.
`75989`	Radiology guidance for vascular imaging and therapeutic procedures, not otherwise classified (e.g., roadmapping/fluoroscopic guidance)	Represents imaging guidance and roadmapping services that accompany intraoperative fluoroscopic procedures.
`77002`	Fluoroscopic guidance for needle placement (e.g., for therapeutic injections)	Illustrates intraoperative fluoroscopic guidance techniques used during catheter placement and balloon occlusion; used when reporting imaging guidance distinct from primary procedure.

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