How To Use CPT Code 37222

CPT 37222 describes the revascularization procedure for an additional narrowed or blocked ipsilateral iliac artery using an endovascular, open, or percutaneous approach, along with transluminal angioplasty. 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 37222?

CPT 37222 can be used to describe the revascularization procedure performed by a healthcare provider to restore blood supply in an additional narrowed or blocked ipsilateral iliac artery. This procedure is done using an endovascular, open, or percutaneous approach, along with transluminal angioplasty. It is important to note that CPT 37222 is an add-on code and should be used in conjunction with the primary procedure codes 37220 and 37221.

2. Official Description

The official description of CPT code 37222 is: ‘Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)’. This code should be used when the provider performs the revascularization procedure on each additional ipsilateral iliac vessel after the initial vessel on the same side.

3. Procedure

1. The healthcare provider prepares the patient for the procedure and ensures they are appropriately prepped and anesthetized.
2. A small incision is made or a needle is inserted through the skin to access the occluded artery.
3. A guidewire is introduced through the opening and used to guide the placement of a catheter.
4. Arteriography is used as imaging guidance to visualize the inside of the blood vessels.
5. The balloon catheter is advanced to the site of the occlusion, and its position is confirmed using angiography.
6. The balloon is inflated at the site of the narrowing or occlusion, expanding the lumen of the vessel.
7. The catheter is then withdrawn, and the site of the incision or puncture in the blood vessel is sutured.
8. The patient’s vital signs and stability are monitored throughout the procedure.

4. Qualifying circumstances

CPT 37222 is performed on patients who have narrowed or blocked ipsilateral iliac arteries that require revascularization. The procedure can be done using an endovascular, open, or percutaneous approach. It is important to note that this code should only be used for additional vessels on the same side as the initial vessel that was treated.

5. When to use CPT code 37222

CPT code 37222 should be used when the healthcare provider performs the revascularization procedure on each additional narrowed or blocked ipsilateral iliac vessel using an endovascular, open, or percutaneous approach, along with transluminal angioplasty. This code should be used in addition to the primary procedure codes 37220 and 37221.

6. Documentation requirements

To support a claim for CPT 37222, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the need for revascularization
• Details of the procedure performed, including the approach used (endovascular, open, or percutaneous)
• Specific vessels treated and their location (ipsilateral iliac arteries)
• Confirmation of the use of transluminal angioplasty
• Documentation of any additional procedures performed during the same session
• Monitoring of the patient’s vital signs and stability
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 37222, ensure that the procedure is performed on each additional narrowed or blocked ipsilateral iliac vessel using an endovascular, open, or percutaneous approach, along with transluminal angioplasty. This code should be listed separately in addition to the primary procedure codes 37220 and 37221. It is important to note that CPT 37222 should not be reported if CPT codes 37223 or other similar codes are already performed in the previous session. It is also essential to consider the appropriate use of modifiers when reporting this code.

8. Historical information

CPT 37222 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs revascularization on an additional narrowed ipsilateral iliac artery using an endovascular approach and transluminal angioplasty.
2. Using a percutaneous approach, a healthcare provider restores blood supply in an additional blocked ipsilateral iliac artery through revascularization and transluminal angioplasty.
3. After performing the primary procedure on the initial vessel, a healthcare provider performs revascularization on an additional narrowed ipsilateral iliac artery using an open approach and transluminal angioplasty.