How To Use CPT Code 36473

CPT 36473 describes the endovenous ablation therapy of incompetent extremity veins, inclusive of all imaging guidance and monitoring, performed percutaneously using a mechanochemical technique. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36473?

CPT 36473 can be used to describe the endovenous ablation therapy of incompetent extremity veins using a mechanochemical technique. This code is used when the provider performs the procedure percutaneously, destroying the thin inner lining of the vein wall using a specially designed mechanochemical ablation device.

2. Official Description

The official description of CPT code 36473 is: ‘Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated.’

3. Procedure

1. The provider creates a small opening in the skin over the affected vein.
2. Under imaging guidance, the provider inserts a guide wire through the vein to the target location.
3. Using ultrasound guidance, the provider passes a hollow tube called a sheath over the guide wire.
4. The provider removes the guide wire and inserts the mechanochemical ablation device through the sheath to the target location.
5. The device consists of a rotating wire inside a catheter, which the provider uses to mechanically damage the thin inner layer of the vein wall.
6. The provider also uses the same device to deliver a sclerosing solution, which inflames the vein’s lining and causes the vessel walls to adhere to each other.
7. After completing the procedure, the provider confirms vein occlusion using ultrasound and applies pressure to control bleeding.

4. Qualifying circumstances

CPT 36473 is performed on patients with incompetent extremity veins, where the venous wall and/or valves are not working effectively. The procedure is suitable for patients who require endovenous ablation therapy using a mechanochemical technique. The use of this code requires the destruction of the thin inner lining of the vein wall and the delivery of a sclerosing solution using a specially designed mechanochemical ablation device.

5. When to use CPT code 36473

CPT code 36473 should be used when the provider performs endovenous ablation therapy of the first incompetent vein in an extremity using a mechanochemical technique. This code is not appropriate for subsequent veins treated in the same extremity. For additional veins, an add-on code should be used.

6. Documentation requirements

To support a claim for CPT 36473, the provider must document the following information:

• Patient’s diagnosis of incompetent extremity veins
• Procedure details, including the use of a mechanochemical ablation device
• Date and time of the procedure
• Confirmation of vein occlusion
• Any additional procedures performed during the same session
• Signature of the provider

7. Billing guidelines

When billing for CPT 36473, ensure that the procedure is performed percutaneously using a mechanochemical technique. The code should only be reported for the first vein treated in an extremity. Additional veins treated in the same extremity should be reported using add-on codes. The use of imaging guidance and monitoring is included in the code and should not be reported separately.

8. Historical information

CPT 36473 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A provider performs endovenous ablation therapy of the first incompetent vein in a patient’s leg using a mechanochemical technique.
2. A patient undergoes percutaneous mechanochemical ablation of an incompetent vein in the arm, with confirmation of vein occlusion.
3. A provider treats the first incompetent vein in a patient’s leg using a mechanochemical technique, followed by the treatment of additional veins using separate access sites.
4. An extremity vein is ablated using a mechanochemical technique, and the provider confirms vein occlusion using ultrasound.
5. A patient receives endovenous ablation therapy of the first incompetent vein in the leg using a mechanochemical technique, with successful vein occlusion.
6. A provider performs percutaneous mechanochemical ablation of an incompetent vein in the arm, documenting the procedure details and confirmation of vein occlusion.
7. An extremity vein is treated using a mechanochemical technique, and the provider notes the successful occlusion of the vein.
8. A patient undergoes endovenous ablation therapy of the first incompetent vein in the leg using a mechanochemical technique, with no complications reported.
9. A provider performs percutaneous mechanochemical ablation of an incompetent vein in the arm, documenting the procedure and confirming vein occlusion.
10. An extremity vein is ablated using a mechanochemical technique, and the provider notes the patient’s tolerance of the procedure.