How To Use CPT Code 37252

CPT 37252 refers to the intravascular ultrasound procedure for the initial noncoronary vessel during diagnostic evaluation and/or therapeutic intervention. This article will cover the code description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of the procedure.

1. What is CPT 37252?

CPT 37252 is a medical code used to describe the intravascular ultrasound (IVUS) procedure performed on the initial noncoronary vessel during diagnostic evaluation and/or therapeutic intervention. This code includes radiological supervision and interpretation of the ultrasound images. IVUS is a minimally invasive procedure that provides detailed images of the interior of blood vessels, allowing healthcare providers to diagnose and treat various vascular conditions.

2. 37252 CPT code description

The official description of CPT code 37252 is: “Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)”.

3. Procedure

The 37252 procedure involves the following steps:

1. The patient is prepped and anesthetized.
2. A small incision is made in the skin over the vessel.
3. A sheath is inserted, and a guide wire is placed through the sheath.
4. An ultrasound catheter with a transducer is inserted over the guide wire into the vessel.
5. The transducer emits high-frequency sound waves, which are converted into images on a video screen.
6. The healthcare provider examines the interior of the vessel using the ultrasound images.
7. The catheter and guide wire are removed once the procedure is complete.
8. The incision is closed, and bleeding is stopped.

4. Qualifying circumstances

Patients eligible to receive CPT code 37252 services are those who require diagnostic evaluation and/or therapeutic intervention for vascular conditions involving noncoronary vessels. Examples of such conditions include peripheral artery disease, renal artery stenosis, and carotid artery stenosis. The healthcare provider will determine the necessity of the IVUS procedure based on the patient’s medical history, symptoms, and results of other diagnostic tests.

5. When to use CPT code 37252

It is appropriate to bill the 37252 CPT code when the healthcare provider performs an intravascular ultrasound on the initial noncoronary vessel during diagnostic evaluation and/or therapeutic intervention. This code should be used in conjunction with the primary procedure code, as it is an add-on code. Failure to report an appropriate primary code may result in denial of reimbursement.

6. Documentation requirements

To support a claim for CPT 37252, the healthcare provider must document the following information:

• Indication for the IVUS procedure, including the patient’s medical history, symptoms, and results of other diagnostic tests.
• Details of the procedure, including the vessel(s) examined, findings, and any interventions performed.
• Radiological supervision and interpretation of the ultrasound images.
• Post-procedure care and follow-up recommendations.

7. Billing guidelines

When billing for CPT code 37252, it is essential to follow the appropriate guidelines and rules. This code is an add-on code and must be reported with an appropriate primary code, as determined by the healthcare provider. Some payers may consider intravascular ultrasound of noncoronary vessels investigational and may not cover the procedure. It is crucial to check with the Medicare provider or private carrier to determine their policies. Even if not covered, the procedure should still be reported for statistical purposes.

8. Historical information

CPT 37252 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Similar codes to CPT 37252

Five similar codes to CPT 37252 and how they differentiate are:

• CPT 37253: This add-on code is used for intravascular ultrasound of each additional noncoronary vessel during diagnostic evaluation and/or therapeutic intervention.
• CPT 37220: This code is used for revascularization procedures involving the iliac artery.
• CPT 37221: This code is used for revascularization procedures involving the femoral, popliteal, or tibial arteries.
• CPT 37224: This code is used for revascularization procedures involving the femoropopliteal artery.
• CPT 37226: This code is used for revascularization procedures involving the tibial or peroneal artery.

10. Examples

Here are 10 detailed examples of CPT code 37252 procedures:

1. IVUS performed during angioplasty of the iliac artery to assess the severity of stenosis and guide stent placement.
2. IVUS performed during renal artery stenting to evaluate the success of the intervention.
3. IVUS used to assess the extent of carotid artery stenosis before carotid endarterectomy.
4. IVUS performed during atherectomy of the femoral artery to guide plaque removal.
5. IVUS used to evaluate the success of angioplasty and stenting of the popliteal artery.
6. IVUS performed during the treatment of an abdominal aortic aneurysm to guide stent-graft placement.
7. IVUS used to assess the severity of renal artery stenosis before angioplasty and stenting.
8. IVUS performed during the treatment of peripheral artery disease to guide balloon angioplasty and stent placement.
9. IVUS used to evaluate the success of atherectomy of the tibial artery.
10. IVUS performed during the treatment of a subclavian artery stenosis to guide angioplasty and stenting.