How To Use CPT Code 37227

CPT 37227 describes the revascularization procedure for the femoral or popliteal 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 37227?

CPT 37227 can be used to describe the revascularization procedure performed on the femoral or popliteal artery. This procedure aims to restore blood supply to a stenosed or narrowed artery using an endovascular, open, or percutaneous approach. The provider may also perform transluminal stent placement and atherectomy, including angioplasty within the same vessel if necessary.

2. Official Description

The official description of CPT code 37227 is: ‘Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed.’

3. Procedure

1. The provider begins by accessing the femoral or popliteal artery through either an endovascular, open, or percutaneous approach.
2. Once access is gained, the provider irrigates the occluded artery with heparin saline to prepare for the procedure.
3. A rotational atherectomy device, also known as a burr catheter, is inserted under radiological guidance to the site of treatment using a guidewire.
4. The provider uses the burr catheter to remove the atherosclerotic plaque from the inner wall of the diseased artery.
5. After the atherectomy, the provider withdraws the catheter and inserts a catheter stent system into the same artery.
6. The stent is placed at the site of occlusion and expanded against the vessel wall to open and recanalize the artery.
7. The provider verifies the patency of the vessel and the extent of revascularization using an angioscope.
8. Finally, the catheter stent system is withdrawn, and the puncture site is either compressed with a bandage or repaired with sutures, depending on the approach used.

4. Qualifying circumstances

CPT 37227 is used for patients with stenosed or narrowed femoral or popliteal arteries who require revascularization. The procedure can be performed using an endovascular, open, or percutaneous approach. The provider must also perform transluminal stent placement and atherectomy, including angioplasty within the same vessel if necessary.

5. When to use CPT code 37227

CPT code 37227 should be used when a provider performs revascularization on the femoral or popliteal artery using an endovascular, open, or percutaneous approach. The procedure must include transluminal stent placement and atherectomy, including angioplasty within the same vessel if necessary.

6. Documentation requirements

To support a claim for CPT 37227, the provider must document the following information:

• Patient’s diagnosis and the need for revascularization
• Approach used (endovascular, open, or percutaneous)
• Date and duration of the procedure
• Specific details of the procedure, including transluminal stent placement, atherectomy, and angioplasty
• Verification of vessel patency and extent of revascularization
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 37227, ensure that the procedure meets the requirements specified in the official description. It is important to note that CPT codes 37224, 37225, 37226, and 37227 should not be reported in conjunction with code 0505T within the femoral-popliteal segment. Additional tips for reporting CPT 37227 can be found in the official documentation.

8. Historical information

CPT 37227 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 provider performs revascularization on a patient’s femoral artery using an endovascular approach, including transluminal stent placement and atherectomy.
2. Using a percutaneous approach, a provider restores blood supply in a patient’s popliteal artery by performing revascularization, including transluminal stent placement and atherectomy.
3. An open approach is used by a provider to perform revascularization on a patient’s femoral artery, including transluminal stent placement and atherectomy.
4. A provider performs revascularization on a patient’s popliteal artery using an endovascular approach, including transluminal stent placement and atherectomy.
5. Using a percutaneous approach, a provider restores blood supply in a patient’s femoral artery by performing revascularization, including transluminal stent placement and atherectomy.