How To Use CPT Code 37140

CPT 37140 describes the procedure for venous anastomosis, specifically the creation of a connection between the portal vein of the liver and the inferior vena cava. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37140?

CPT 37140 involves the creation of a venous anastomosis, specifically connecting the portal vein of the liver to the inferior vena cava. This procedure is performed to treat portal hypertension, which is caused by a narrowing or blockage of the portal vein. By creating this connection, the pressure in the veins of the stomach and esophagus is reduced, preventing severe bleeding in the gastrointestinal tract.

2. Official Description

The official description of CPT code 37140 is: ‘Venous anastomosis, open; portocaval.’ This code is used when the provider performs a surgical procedure to create a connection between the portal vein and the inferior vena cava.

3. Procedure

1. The provider begins by making an incision that extends from the chest to the abdomen.
2. They then dissect through the subcutaneous tissue to expose the liver and inferior vena cava.
3. The portal vein of the liver and the inferior vena cava are identified, and clamps are placed over both vessels to stop blood flow.
4. The provider incises a portion of both the portal vein and the inferior vena cava along their length.
5. Using sutures, they connect the portal vein to the inferior vena cava, creating an anastomosis between the two vessels.
6. The clamps are removed, and the provider ensures that there is no blood leakage and that proper blood flow is restored.
7. Finally, they stop any bleeding and close the incision by suturing the soft tissue layers. In some cases, a chest tube may be placed for drainage.

4. Qualifying circumstances

CPT 37140 is performed to treat portal hypertension, which is characterized by high blood pressure in the veins and branches of the portal venous system. This procedure is suitable for patients with portal hypertension caused by a narrowing or blockage of the portal vein. It is important to note that this procedure requires a qualified provider who is skilled in performing venous anastomosis.

5. When to use CPT code 37140

CPT code 37140 should be used when a provider performs an open venous anastomosis procedure to create a connection between the portal vein and the inferior vena cava. This code is appropriate for cases of portal hypertension caused by a narrowing or blockage of the portal vein. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

When documenting a claim for CPT 37140, the provider must include the following information:

• Patient’s diagnosis of portal hypertension
• Description of the procedure performed, including the creation of a venous anastomosis between the portal vein and the inferior vena cava
• Date of the procedure
• Details of the surgical approach and any additional techniques used
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up plans
• Provider’s signature

7. Billing guidelines

When billing for CPT 37140, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should be skilled in performing venous anastomosis and should document the procedure accurately. It is also important to follow any additional billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 37140 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. However, it is important to stay updated with any changes or revisions to the code in future coding cycles.

9. Examples

1. A patient with portal hypertension undergoes a venous anastomosis procedure to create a connection between the portal vein and the inferior vena cava.
2. A provider performs an open venous anastomosis to treat severe bleeding in the gastrointestinal tract caused by portal hypertension.
3. During surgery, a connection is established between the portal vein and the inferior vena cava to relieve the pressure in the veins of the stomach and esophagus.
4. A qualified provider performs a venous anastomosis procedure to address portal hypertension resulting from a narrowing of the portal vein.
5. A patient with portal hypertension undergoes an open surgical procedure to create an anastomosis between the portal vein and the inferior vena cava.
6. During the procedure, the provider carefully connects the portal vein and the inferior vena cava to restore proper blood flow and reduce the risk of severe bleeding.
7. A venous anastomosis is performed to alleviate the symptoms of portal hypertension and prevent complications in a patient.
8. The provider successfully creates a connection between the portal vein and the inferior vena cava, effectively lowering the pressure in the veins of the stomach and esophagus.
9. A patient with portal hypertension undergoes a surgical procedure to establish a venous anastomosis between the portal vein and the inferior vena cava.
10. The provider performs an open venous anastomosis to treat portal hypertension and prevent further complications.