How To Use CPT Code 37192

CPT 37192 describes the repositioning of an intravascular vena cava filter using an endovascular approach. 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 37192?

CPT 37192 can be used to describe the repositioning of an intravascular vena cava filter using an endovascular approach. This code is used when a healthcare provider uses imaging guidance, such as ultrasound and fluoroscopy, to reposition an already placed filter device in the inferior vena cava (IVC). The purpose of this procedure is to ensure that the filter is in the appropriate position to prevent blood clots from traveling to the heart and lungs.

2. Official Description

The official description of CPT code 37192 is: ‘Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.’

3. Procedure

1. The healthcare provider selects the appropriate access vein, either at the groin level or the neck, based on the location and number of identified blood clots within the venous system.
2. A catheter and guide wire are inserted into the chosen vein, and the catheter is connected to a fluoroscope or ultrasound machine for imaging guidance.
3. The provider assesses the position of the existing filter within the IVC and evaluates the diameter of the vein to determine the appropriate repositioning.
4. A telescoping filter retrieval sheath with a device is advanced into the access vein along the guide wire to reach the IVC.
5. The provider carefully grasps the cone of the filter with the device and collapses the filter into the telescoping sheath system, ensuring no damage to the caval wall.
6. Using imaging guidance, the provider re-deploys the filter to a more suitable location within the IVC based on fluoroscopic findings.
7. The provider confirms the deployment and alignment of the filter within the vena cava using fluoroscopy.
8. The guide wire and filter delivery sheath are removed, and the puncture site is treated to stop bleeding, potentially using a hemostasis assist device.

4. Qualifying circumstances

CPT 37192 is performed on patients who already have an intravascular vena cava filter in place and require repositioning. The procedure is necessary to ensure that the filter is in the correct position to prevent blood clots from traveling to vital organs. The healthcare provider must use imaging guidance, such as ultrasound and fluoroscopy, during the procedure to visualize the blood vessels and accurately reposition the filter. It is important to note that CPT code 37192 should not be reported in conjunction with CPT code 37191.

5. When to use CPT code 37192

CPT code 37192 should be used when a healthcare provider needs to reposition an intravascular vena cava filter using an endovascular approach. This code is appropriate when the procedure includes vascular access, vessel selection, radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy). It is important to note that CPT code 37192 should not be reported with CPT code 37191.

6. Documentation requirements

To support a claim for CPT code 37192, the healthcare provider must document the following information:

• Patient’s medical history and the need for repositioning of the vena cava filter
• Specific details of the procedure, including vascular access, vessel selection, and imaging guidance used
• Date and duration of the procedure
• Fluoroscopic and ultrasound findings
• Confirmation of the filter’s deployment and alignment within the vena cava
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 37192, ensure that the procedure includes all the components described in the official description. It is important to note that CPT code 37192 should not be reported in conjunction with CPT code 37191. Additionally, providers should follow any specific guidelines or requirements from the payer regarding documentation and billing for this procedure.

8. Historical information

CPT code 37192 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider repositions an intravascular vena cava filter using an endovascular approach in a patient with a history of deep vein thrombosis.
2. During the procedure, the provider uses imaging guidance to accurately reposition the filter to prevent pulmonary embolism in a patient with a known clotting disorder.
3. A patient with a previously placed vena cava filter undergoes repositioning to ensure its optimal placement and effectiveness in preventing blood clots.
4. The healthcare provider performs the procedure to reposition an intravascular vena cava filter in a patient who experienced filter migration.
5. In a patient with a history of multiple blood clots, the provider repositions the vena cava filter to a more suitable location to enhance its efficacy.