How To Use CPT Code 37223

CPT 37223 describes the revascularization procedure for the iliac artery using endovascular, open, or percutaneous approaches, with the placement of transluminal stents and angioplasty if necessary. 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 37223?

CPT 37223 can be used to describe the revascularization procedure performed on an additional ipsilateral iliac vessel after the initial procedure on the same side. The provider uses endovascular, open, or percutaneous approaches to restore blood supply and may place transluminal stents and perform angioplasty if needed.

2. Official Description

The official description of CPT code 37223 is: ‘Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider prepares the patient and makes a small incision or punctures the occluded iliac artery.
2. A guidewire is inserted through the opening, followed by the introduction of a catheter.
3. Using arteriography for guidance, the provider advances a stent delivering catheter to the site of occlusion.
4. The stent is placed at the occlusion site and expanded against the vessel wall to increase its diameter.
5. Angiography is performed to confirm the position of the stent.
6. The catheter is withdrawn, and the incision or puncture site is sutured.
7. The patient’s vital signs and stability are monitored throughout the procedure.

4. Qualifying circumstances

CPT 37223 is used when the provider performs revascularization on an additional ipsilateral iliac vessel after the initial procedure on the same side. The procedure may involve endovascular, open, or percutaneous approaches, and may include the placement of transluminal stents and angioplasty within the same vessel.

5. When to use CPT code 37223

CPT code 37223 should be used when the provider performs revascularization on each additional ipsilateral iliac vessel after the initial procedure on the same side. This code is appropriate when transluminal stent placement and angioplasty are performed within the same vessel. It should not be used for the initial procedure or for revascularization on contralateral iliac vessels.

6. Documentation requirements

To support a claim for CPT 37223, the provider must document the following information:

• Indication for the revascularization procedure
• Details of the procedure, including the approach used (endovascular, open, or percutaneous)
• Specific vessels treated and the number of additional ipsilateral iliac vessels
• Description of any transluminal stent placement and angioplasty performed
• Date and duration of the procedure
• Confirmation of the stent position using angiography
• Monitoring of the patient’s vital signs and stability
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 37223, ensure that the procedure meets the criteria for each additional ipsilateral iliac vessel revascularization with transluminal stent placement and angioplasty. It is important to use this code in conjunction with the primary procedure code. Be aware of any specific guidelines or restrictions related to reporting CPT 37223 with other codes. It is recommended to review the complete billing guidelines and seek clarification if needed.

8. Historical information

CPT 37223 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 patient undergoes revascularization of an additional ipsilateral iliac vessel using endovascular approach with transluminal stent placement and angioplasty.
2. The provider performs revascularization on a second ipsilateral iliac vessel using open approach with transluminal stent placement and angioplasty.
3. During the procedure, the provider restores blood supply in a third ipsilateral iliac vessel using percutaneous approach with transluminal stent placement and angioplasty.
4. Revascularization is performed on a fourth ipsilateral iliac vessel using endovascular approach with transluminal stent placement and angioplasty.
5. The provider performs revascularization on a fifth ipsilateral iliac vessel using open approach with transluminal stent placement and angioplasty.
6. Another patient undergoes revascularization of an additional ipsilateral iliac vessel using percutaneous approach with transluminal stent placement and angioplasty.
7. The provider restores blood supply in a second ipsilateral iliac vessel using endovascular approach with transluminal stent placement and angioplasty.
8. During the procedure, revascularization is performed on a third ipsilateral iliac vessel using open approach with transluminal stent placement and angioplasty.
9. The provider performs revascularization on a fourth ipsilateral iliac vessel using percutaneous approach with transluminal stent placement and angioplasty.