How To Use CPT Code 37238

CPT 37238 refers to the transcatheter placement of an intravascular stent in a vein, including radiological supervision and interpretation, and angioplasty when performed. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 37238.

1. What is CPT 37238?

CPT 37238 is a medical procedure code that describes the transcatheter placement of an intravascular stent in a vein, including radiological supervision and interpretation, and angioplasty when performed. This code is used to report the specific procedure performed by a physician to treat a patient with a vascular abnormality in a vein.

2. 37238 CPT code description

The official description of CPT code 37238 is: “Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein.”

3. Procedure

The 37238 procedure involves the following steps:

  1. The patient is prepped and anesthesia is administered.
  2. If the physician uses an open technique, an incision is made for vessel exposure. If a percutaneous transcatheter stent placement technique is employed, a small incision is made to access the vessel through the skin.
  3. The physician advances a catheter through the vessels toward the area requiring treatment.
  4. Contrast material is administered into the vessel to investigate the exact location and extent of the vascular abnormality.
  5. Angioplasty may be performed to prepare the site.
  6. The catheter stent system is inserted into the lumen of the affected initial vessel, with the assistance of a guidewire.
  7. The stent is delivered at the site of vascular occlusion to increase the diameter of the stenosed vessel.
  8. Radiological guidance may be used to monitor the stent placement inside the vessel lumen.
  9. The catheter is withdrawn when the appropriate level of recanalization of the occluded vessel is achieved through stent delivery.
  10. The physician closes the access site using pressure, an arterial closure device, or suture.

4. Qualifying circumstances

Patients eligible to receive CPT code 37238 services are those with a vascular abnormality in a vein that requires the placement of an intravascular stent. This may include patients with conditions such as deep vein thrombosis, venous stenosis, or other venous occlusions. The decision to perform this procedure is based on the physician’s assessment of the patient’s medical condition and the potential benefits and risks associated with the intervention.

5. When to use CPT code 37238

It is appropriate to bill the 37238 CPT code when a physician performs a transcatheter placement of an intravascular stent in a vein, including radiological supervision and interpretation, and angioplasty when performed. This code should be used to report the specific procedure performed to treat a patient with a vascular abnormality in a vein. It is essential to ensure that the procedure performed aligns with the description of CPT 37238 and that all necessary documentation is provided to support the claim.

6. Documentation requirements

To support a claim for CPT 37238, the following information should be documented:

  • Patient’s medical history and diagnosis, including the presence of a vascular abnormality in a vein that requires stent placement.
  • Details of the procedure performed, including the technique used (open or percutaneous), the type and size of the stent, and the specific vein treated.
  • Radiological supervision and interpretation, including the use of contrast material and any angioplasty performed.
  • Post-procedure assessment, including the outcome of the stent placement and any complications or additional interventions required.
  • Follow-up care plan, including any necessary medications, monitoring, or additional procedures.

7. Billing guidelines

When billing for CPT code 37238, it is essential to follow the appropriate guidelines and rules. These may include:

  • Ensuring that the procedure performed aligns with the description of CPT 37238.
  • Providing all necessary documentation to support the claim, as outlined in the documentation requirements section.
  • Reviewing any applicable payer-specific guidelines or policies related to CPT 37238.
  • Being aware of any relevant coding updates or changes that may impact the billing of CPT 37238.

8. Historical information

CPT 37238 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates to the code since its addition.

9. Similar codes to CPT 37238

Five similar codes to CPT 37238 and how they differentiate from CPT 37238 are:

  • CPT 37239: This code is used for additional veins treated with stent placement during the same session as CPT 37238.
  • CPT 37236: This code is used for the initial artery treated with stent placement, rather than a vein.
  • CPT 37237: This code is used for additional arteries treated with stent placement during the same session as CPT 37236.
  • CPT 37220: This code is used for revascularization of an occluded lower extremity artery using an endovascular technique, without stent placement.
  • CPT 37221: This code is used for revascularization of an occluded lower extremity artery using an endovascular technique, with stent placement.

10. Examples

Here are 10 detailed examples of CPT code 37238 procedures:

  1. A patient with deep vein thrombosis in the iliac vein undergoes a percutaneous transcatheter stent placement to restore blood flow.
  2. A patient with venous stenosis in the subclavian vein undergoes an open transcatheter stent placement, including angioplasty, to improve blood flow.
  3. A patient with a chronic venous occlusion in the femoral vein undergoes a percutaneous transcatheter stent placement with radiological supervision and interpretation.
  4. A patient with May-Thurner syndrome undergoes a percutaneous transcatheter stent placement in the iliac vein to alleviate compression and improve blood flow.
  5. A patient with a venous stenosis in the brachiocephalic vein undergoes an open transcatheter stent placement, including angioplasty and radiological supervision and interpretation.
  6. A patient with a chronic venous occlusion in the popliteal vein undergoes a percutaneous transcatheter stent placement to restore blood flow and alleviate symptoms.
  7. A patient with a venous stenosis in the axillary vein undergoes an open transcatheter stent placement, including angioplasty and radiological supervision and interpretation.
  8. A patient with a chronic venous occlusion in the jugular vein undergoes a percutaneous transcatheter stent placement to improve blood flow and alleviate symptoms.
  9. A patient with a venous stenosis in the innominate vein undergoes an open transcatheter stent placement, including angioplasty and radiological supervision and interpretation.
  10. A patient with a chronic venous occlusion in the tibial vein undergoes a percutaneous transcatheter stent placement to restore blood flow and alleviate symptoms.

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