How To Use CPT Code 37236

CPT 37236 refers to the transcatheter placement of an intravascular stent in an artery, excluding specific arteries, and includes radiological supervision, interpretation, and angioplasty within the same vessel. This article will cover the description, procedure, qualifying circumstances, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 37236.

1. What is CPT 37236?

CPT 37236 is a medical procedure code used to describe the transcatheter placement of an intravascular stent in an artery, excluding specific arteries such as lower extremity, cervical carotid, extracranial vertebral, intrathoracic carotid, intracranial, and coronary arteries. The code includes radiological supervision, interpretation, and angioplasty within the same vessel when performed.

2. 37236 CPT code description

The official description of CPT code 37236 is: “Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery.”

3. Procedure

The 37236 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. If using an open technique, the physician makes an incision in the skin over the vessel for exposure and incises the vessel longitudinally to access the area requiring a stent.
3. If using a percutaneous transcatheter stent placement technique, the physician makes a small incision in the skin over an area proximal or distal to the area requiring a stent.
4. Using a needle and guide wire to enter the vessel, the physician advances a catheter over the guide wire toward the area requiring treatment.
5. The physician injects contrast material into the vessel to locate the exact area of narrowing and determine the extent of the narrowing.
6. Angioplasty may be performed to prepare the site.
7. The stent is delivered to the site of the occlusion to increase the diameter of the stenosed vessel and keep it open.
8. Radiological guidance is used to place the stent inside the vessel lumen.
9. The physician withdraws the catheter when the vessel is sufficiently open.
10. The access site is closed using pressure, an arterial closure device, or suture.

4. Qualifying circumstances

Patients eligible to receive CPT code 37236 services are those who require the placement of an intravascular stent in an artery, excluding the specific arteries mentioned in the code description. The stent placement may be necessary due to conditions such as arterial stenosis, occlusion, or aneurysm. The patient’s medical history, symptoms, and diagnostic tests will determine the need for this procedure.

5. When to use CPT code 37236

It is appropriate to bill the 37236 CPT code when a provider performs the transcatheter placement of an intravascular stent in an artery, excluding the specific arteries mentioned in the code description, and includes radiological supervision, interpretation, and angioplasty within the same vessel when performed.

6. Documentation requirements

To support a claim for CPT 37236, the following information should be documented:

• Patient’s medical history and symptoms
• Diagnostic tests and their results
• Indication for the procedure
• Details of the procedure, including the technique used (open or percutaneous), the type of stent placed, and the specific artery treated
• Radiological supervision and interpretation
• Angioplasty performed within the same vessel, if applicable
• Post-procedure findings and outcomes

7. Billing guidelines

When billing for CPT code 37236, keep in mind the following guidelines and rules:

• Do not report radiological supervision and interpretation separately, as they are included in the code.
• Do not report angioplasty separately when performed within the same vessel, as it is included in the code.
• For each additional artery treated, use the add-on code +37237.
• Be aware of similar codes and their differences to ensure accurate billing.

8. Historical information

CPT 37236 was added to the Current Procedural Terminology system on January 1, 2014. The code was changed on January 1, 2015, with the previous descriptor being “Transcatheter placement of an intravascular stent(s) (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery.”

9. Similar codes to CPT 37236

Five similar codes to CPT 37236 and how they differentiate are:

• CPT 37237: This add-on code is used for each additional artery treated during the same procedure.
• CPT 37238: This code is used for the transcatheter placement of an intravascular stent in a vein, rather than an artery.
• CPT 37239: This add-on code is used for each additional vein treated during the same procedure.
• CPT 37215: This code is used for stent placement in the cervical carotid artery.
• CPT 37221: This code is used for stent placement in the lower extremity artery for occlusive disease.

10. Examples

Here are 10 detailed examples of CPT code 37236 procedures:

1. Transcatheter placement of a stent in the renal artery for a patient with renal artery stenosis.
2. Transcatheter placement of a stent in the subclavian artery for a patient with subclavian artery occlusion.
3. Transcatheter placement of a stent in the iliac artery for a patient with iliac artery aneurysm.
4. Transcatheter placement of a stent in the brachial artery for a patient with brachial artery stenosis.
5. Transcatheter placement of a stent in the axillary artery for a patient with axillary artery occlusion.
6. Transcatheter placement of a stent in the celiac artery for a patient with celiac artery stenosis.
7. Transcatheter placement of a stent in the superior mesenteric artery for a patient with superior mesenteric artery occlusion.
8. Transcatheter placement of a stent in the hepatic artery for a patient with hepatic artery aneurysm.
9. Transcatheter placement of a stent in the splenic artery for a patient with splenic artery stenosis.
10. Transcatheter placement of a stent in the gastroduodenal artery for a patient with gastroduodenal artery occlusion.