Summary & Overview
CPT 61623: Temporary Balloon Occlusion of Neck Arteries Assisting Vascular Procedure
CPT code 61623 denotes temporary balloon occlusion (TBO) of neck arteries used as an adjunct to another vascular or neurovascular procedure, such as aneurysm repair. Nationally, the code captures targeted, time-limited endovascular control of arterial flow to reduce bleeding risk or prevent embolic complications during complex intracranial or extracranial interventions. Its appropriate use affects care coordination, intraoperative risk management, and billing for adjunctive endovascular techniques.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent, common sites of service, and how this adjunctive procedure is classified for billing purposes. The publication outlines benchmark considerations for payer coverage patterns, typical clinical contexts where TBO is applied, and relevant billing guidance implications. It also highlights common modifiers and service-line considerations for reporting adjunctive endovascular maneuvers when present. Data not available in the input is noted where applicable.
This summary equips clinicians, coding staff, and payers with a focused reference on CPT code 61623 — what it represents, where it is typically performed, and why accurate coding matters for perioperative management and claims processing.
Billing Code Overview
CPT code 61623 describes a procedure using temporary balloon occlusion (TBO) to control arterial blood flow in the neck during another endovascular or open vascular procedure, such as repair of a cerebral aneurysm. The technique involves transient balloon inflation in carotid or vertebral arteries to reduce perfusion or prevent distal embolization while the principal procedure is performed.
Service type: Endovascular vascular adjunct (temporary balloon occlusion) performed to assist another neurovascular or vascular procedure
Typical site of service: Hospital inpatient, hospital outpatient, or specialized endovascular/surgical suite where neurointerventional or vascular procedures are performed
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents with a large, saccular intracranial aneurysm of the internal carotid artery planned for endovascular repair. During the endovascular aneurysm repair, the neurointerventionalist performs temporary balloon occlusion (TBO) of the cervical internal carotid artery to control antegrade blood flow, protect distal branches, and facilitate coil deployment or flow-diverter placement. The workflow includes pre-procedure angiographic planning, conscious sedation or general anesthesia in an angiography suite or hybrid OR, arterial access (femoral or radial), microcatheter navigation to the target artery, inflation of a compliant occlusion balloon for a defined interval under fluoroscopic monitoring, performance of the definitive aneurysm repair (coiling or stent/flow diverter), deflation and removal of the balloon, angiographic confirmation of vessel and aneurysm status, hemostasis of the access site, and post-procedure neurovascular monitoring in a PACU or neurocritical care unit. Documentation should record indication, duration and location of balloon occlusion, hemodynamic and neurologic monitoring, any adjunctive devices used, and discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/technical performance split applies (rare for endovascular procedures billed global). |