How To Use CPT Code 37228

CPT 37228 describes the revascularization procedure for the unilateral tibial or peroneal 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 37228?

CPT 37228 is used to describe a revascularization procedure performed on the unilateral tibial or peroneal artery. The procedure can be done using an endovascular, open, or percutaneous approach. The provider uses transluminal angioplasty to restore the blood supply in the affected artery. This 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 37228 is: ‘Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty.’

3. Procedure

1. The provider assesses the occlusion in the unilateral tibial or peroneal artery.
2. Depending on the approach chosen, the provider either makes an incision in the skin over the affected artery (open approach) or punctures the vessel using a needle through the skin (percutaneous approach).
3. A guidewire is inserted into the artery using the needle and advanced to the site of the occlusion.
4. The needle is removed, and a balloon catheter is introduced into the artery using the guidewire.
5. The provider confirms the position of the catheter using angiography.
6. The balloon is inflated at the site of the occlusion, expanding the lumen of the narrowed artery.
7. The provider ensures that the blood supply is restored using imaging guidance.
8. If a percutaneous approach was used, a compression bandage is applied to stop bleeding. If an open approach was used, the vertical incision is repaired by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 37228 is used when the provider performs the revascularization procedure on the initial vessel of the unilateral tibial or peroneal artery. The procedure can be done using an endovascular, open, or percutaneous approach. The patient must have an occlusion in the artery that requires restoration of blood supply.

5. When to use CPT code 37228

CPT code 37228 should be used when the provider performs the revascularization procedure on the initial vessel of the unilateral tibial or peroneal artery. It is important to note that this code is specific to the transluminal angioplasty procedure. If additional vessels or different procedures are involved, different codes should be used.

6. Documentation requirements

To support a claim for CPT 37228, the provider must document the following information:

• The diagnosis indicating the need for revascularization
• The specific approach used (endovascular, open, or percutaneous)
• Date of the procedure
• Details of the procedure, including the use of transluminal angioplasty
• Confirmation of restored blood supply
• Signature of the provider

7. Billing guidelines

When billing for CPT 37228, ensure that the procedure meets the criteria for the code. The provider should use the appropriate approach (endovascular, open, or percutaneous) and perform transluminal angioplasty. It is important to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT 37228 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 the initial tibial artery of a patient using an endovascular approach and transluminal angioplasty.
2. Using a percutaneous approach, a provider restores blood supply in the peroneal artery of a patient through transluminal angioplasty.
3. An open approach is used by a provider to perform revascularization on the initial tibial artery of a patient using transluminal angioplasty.
4. A provider performs revascularization on the initial peroneal artery of a patient using an endovascular approach and transluminal angioplasty.
5. Using a percutaneous approach, a provider restores blood supply in the tibial artery of a patient through transluminal angioplasty.
6. An open approach is used by a provider to perform revascularization on the initial peroneal artery of a patient using transluminal angioplasty.
7. A provider performs revascularization on the initial tibial artery of a patient using an endovascular approach and transluminal angioplasty.
8. Using a percutaneous approach, a provider restores blood supply in the peroneal artery of a patient through transluminal angioplasty.