How To Use CPT Code 37184

CPT 37184 describes a procedure known as primary percutaneous transluminal mechanical thrombectomy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37184?

CPT 37184 is a code used to describe a specific medical procedure. This procedure, known as primary percutaneous transluminal mechanical thrombectomy, is performed by a healthcare provider to treat an occlusion or blockage in a noncoronary or non-intracranial artery or in an arterial bypass graft. The procedure involves the use of mechanical thrombectomy, which is the use of tiny surgical tools to break down a blood clot, and pharmacological thrombolytic injection, which is the use of a drug to dissolve the blood clot. The provider also uses fluoroscopic guidance, which is the use of live X-ray imaging, to perform the procedure. CPT 37184 is specifically used when the procedure is performed on the initial vessel.

2. Official Description

The official description of CPT code 37184 is: ‘Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel.’

3. Procedure

1. The healthcare provider begins by appropriately prepping and anesthetizing the patient.
2. Next, the provider accesses the site of the artery or arterial bypass graft and places vascular clamps across the affected initial artery.
3. Angiography may be used to confirm the blocked arteries.
4. The provider then performs an arterial puncture to insert a specially designed catheter system into the first blocked vessel.
5. An arterial irrigation is performed by injecting a heparin saline through the site of access.
6. A fiberoptic angioscope is used to identify the exact location of arterial thrombosis.
7. Using fluoroscopic guidance, the provider inserts a guidewire into the artery and advances the catheter over the guidewire to the site of occlusion.
8. The provider manipulates the tip of the catheter system to the site of occlusion inside the diseased artery and injects an appropriate thrombolytic agent to achieve complete fragmentation of the clot.
9. Any clot fragments are suctioned out from the affected artery to restore its blood supply.
10. Finally, the catheter system is removed, and bleeding is stopped by applying pressure at the site of entry.

4. Qualifying circumstances

CPT 37184 is performed on patients who have an occlusion or blockage in a noncoronary or non-intracranial artery or in an arterial bypass graft. The procedure is performed by a healthcare provider using a combined technique of mechanical thrombectomy and pharmacological thrombolytic injection. Fluoroscopic guidance is used during the procedure. It is important to note that CPT 37184 should not be reported in conjunction with codes 61645, 76000, or 96374.

5. When to use CPT code 37184

CPT code 37184 should be used when a healthcare provider performs the primary percutaneous transluminal mechanical thrombectomy procedure on the initial vessel. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of mechanical thrombectomy, pharmacological thrombolytic injection, and fluoroscopic guidance.

6. Documentation requirements

To support a claim for CPT 37184, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Specific details of the procedure performed, including the use of mechanical thrombectomy, pharmacological thrombolytic injection, and fluoroscopic guidance
• Date and duration of the procedure
• Any additional relevant information or findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 37184, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should not be reported in conjunction with codes 61645, 76000, or 96374. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 37184 was added to the Current Procedural Terminology system on January 1, 2006. The code has undergone a change on January 1, 2016, with an updated description.

9. Examples

1. A healthcare provider performs primary percutaneous transluminal mechanical thrombectomy on the initial vessel of a patient with an occlusion in a noncoronary artery.
2. Using fluoroscopic guidance, a provider performs the procedure on the initial vessel of a patient with an occlusion in an arterial bypass graft.
3. A healthcare provider performs primary percutaneous transluminal mechanical thrombectomy on the initial vessel of a patient with an occlusion in a non-intracranial artery.
4. Using mechanical thrombectomy and pharmacological thrombolytic injection, a provider performs the procedure on the initial vessel of a patient with an occlusion in a noncoronary artery.
5. A healthcare provider uses fluoroscopic guidance to perform primary percutaneous transluminal mechanical thrombectomy on the initial vessel of a patient with an occlusion in an arterial bypass graft.