How To Use CPT Code 37220

CPT 37220 describes the revascularization procedure for the iliac artery using an endovascular, open, or percutaneous 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 37220?

CPT 37220 is used to describe a revascularization procedure for the iliac artery. This procedure is performed by a healthcare provider to restore blood supply in a narrowed or blocked unilateral iliac artery. The provider can use an endovascular, open, or percutaneous approach to perform the procedure. During the procedure, a transluminal angioplasty is performed, which involves placing a balloon catheter at the site of the occlusion and inflating it to expand the lumen of the vessel.

2. Official Description

The official description of CPT code 37220 is: ‘Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. A small incision is made or a needle is inserted through the skin to puncture the occluded artery.
3. A guidewire is introduced through the opening, and a catheter is threaded over the guidewire into the artery.
4. Arteriography is used as imaging guidance to confirm the position of the catheter.
5. A balloon catheter is advanced to the site of occlusion, and the balloon is inflated to expand the lumen of the vessel.
6. The catheter is then withdrawn, and the site of the incision or puncture in the blood vessel is sutured.
7. The patient’s vital signs and stability are monitored throughout the procedure.

4. Qualifying circumstances

CPT 37220 is used when a healthcare provider performs a revascularization procedure on the initial vessel of a unilateral iliac artery. This procedure is typically performed on patients with a narrowed or blocked iliac artery that requires restoration of blood supply. The provider can use an endovascular, open, or percutaneous approach, depending on the patient’s specific condition and circumstances.

5. When to use CPT code 37220

CPT code 37220 should be used when a healthcare provider performs a revascularization procedure on the initial vessel of a unilateral iliac artery using an endovascular, open, or percutaneous approach. This code is appropriate when the provider performs a transluminal angioplasty during the procedure. It should not be used for subsequent vessels or if a stent placement is performed instead of an angioplasty.

6. Documentation requirements

To support a claim for CPT 37220, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for revascularization
• Details of the procedure, including the approach used (endovascular, open, or percutaneous)
• Date and duration of the procedure
• Confirmation of the site of occlusion and the position of the catheter using arteriography
• Details of the angioplasty, including the inflation of the balloon and expansion of the vessel lumen
• Monitoring of the patient’s vital signs and stability throughout the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 37220, ensure that the procedure is performed on the initial vessel of a unilateral iliac artery using an endovascular, open, or percutaneous approach. Do not report CPT 37220 if a stent placement is performed instead of an angioplasty. There are additional codes available for reporting revascularization procedures on subsequent vessels or when a stent placement is performed. It is important to follow the specific guidelines and tips provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 37220 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs a revascularization procedure on the initial vessel of a unilateral iliac artery using an endovascular approach and performs a transluminal angioplasty to expand the vessel lumen.
2. Using a percutaneous approach, a healthcare provider restores blood supply in a narrowed iliac artery by performing a revascularization procedure on the initial vessel and performing a transluminal angioplasty.
3. An open approach is used by a healthcare provider to perform a revascularization procedure on the initial vessel of a unilateral iliac artery and perform a transluminal angioplasty to restore blood supply.
4. A healthcare provider performs a revascularization procedure on the initial vessel of a unilateral iliac artery using an endovascular approach and performs a transluminal angioplasty to expand the vessel lumen.
5. Using a percutaneous approach, a healthcare provider restores blood supply in a narrowed iliac artery by performing a revascularization procedure on the initial vessel and performing a transluminal angioplasty.