How To Use CPT Code 37188

CPT 37188 describes a percutaneous transluminal mechanical thrombectomy procedure for the treatment of an occlusion in a vein. 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 37188?

CPT 37188 can be used to describe a percutaneous transluminal mechanical thrombectomy procedure for the treatment of an occlusion, or blockage, in a vein. This code is used when the provider repeats the treatment on a subsequent day during the course of thrombolytic therapy. The procedure involves the use of mechanical thrombectomy and pharmacological thrombolytic injections, with the guidance of fluoroscopy, to remove the blood clot from the vein.

2. Official Description

The official description of CPT code 37188 is: ‘Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy.’

3. Procedure

1. The provider accesses the affected vein through a small incision at the groin or below the knee area.
2. A venography is performed to locate the exact site of the clot in the vein.
3. Under fluoroscopic guidance, a guidewire is inserted to the site of occlusion.
4. A catheter with a mechanical device or high-speed water jet at its tip is threaded over the guidewire to break down the clot.
5. Pharmacological thrombolytic injections are administered to further dissolve the clot.
6. All instruments are removed, and bleeding is stopped by applying pressure at the site of entry.

4. Qualifying circumstances

CPT 37188 is used for patients who require a repeat treatment for an occlusion in a vein during the course of thrombolytic therapy. The procedure is performed by a provider who is appropriately trained and qualified to perform percutaneous transluminal mechanical thrombectomy. It is important to note that CPT 37188 should not be reported in conjunction with CPT codes 76000 and 96375.

5. When to use CPT code 37188

CPT code 37188 should be used when the provider performs a repeat treatment for an occlusion in a vein on a subsequent day during the course of thrombolytic therapy. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 37188, the provider must document the following information:

• Patient’s diagnosis and the need for repeat treatment
• Details of the procedure, including the specific veins treated and the use of mechanical thrombectomy and pharmacological thrombolytic injections
• Date of the procedure and the subsequent day during the course of thrombolytic therapy
• Fluoroscopic guidance used during the procedure
• Progress made in removing the clot and any complications encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 37188, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that CPT 37188 should not be reported in conjunction with CPT codes 76000 and 96375. Additional tips for accurate billing may include considering the location of the testing and the use of modifiers, if applicable.

8. Historical information

CPT 37188 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a repeat percutaneous transluminal mechanical thrombectomy procedure on a subsequent day during the course of thrombolytic therapy to remove a clot in a patient’s femoral vein.
2. A patient undergoes a percutaneous transluminal mechanical thrombectomy procedure for the treatment of an occlusion in the popliteal vein. The provider repeats the procedure on a subsequent day during the course of thrombolytic therapy.
3. A provider performs a repeat percutaneous transluminal mechanical thrombectomy procedure to remove a clot in a patient’s vein below the knee. The procedure is performed on a subsequent day during the course of thrombolytic therapy.
4. A patient undergoes a percutaneous transluminal mechanical thrombectomy procedure for the treatment of an occlusion in the saphenous vein. The provider repeats the procedure on a subsequent day during the course of thrombolytic therapy.
5. A provider performs a repeat percutaneous transluminal mechanical thrombectomy procedure to remove a clot in a patient’s vein. The procedure is performed on a subsequent day during the course of thrombolytic therapy.
6. A patient undergoes a percutaneous transluminal mechanical thrombectomy procedure for the treatment of an occlusion in the femoral vein. The provider repeats the procedure on a subsequent day during the course of thrombolytic therapy.