How To Use CPT Code 37232

CPT 37232 describes the procedure for revascularization of the tibial or peroneal artery using an endovascular, open, or percutaneous approach. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37232?

CPT 37232 can be used to describe the procedure performed by a healthcare provider to restore blood supply in each additional unilateral tibial or peroneal artery. This is done through an endovascular, open, or percutaneous approach, using transluminal angioplasty. The code is an add-on procedure and should be used when the provider performs this procedure on each additional vessel after the initial procedure on a tibial or peroneal vessel.

2. Official Description

The official description of CPT code 37232 is: ‘Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)’

3. Procedure

1. The healthcare provider restores the blood supply in each additional unilateral tibial or peroneal artery using an endovascular, open, or percutaneous approach.
2. The provider may use transluminal angioplasty, which involves placing a balloon catheter at the site of an occlusion in the blood vessel and inflating the balloon to expand the lumen of the vessel.
3. The procedure may be performed with an open approach, where the provider makes an incision in the skin over the artery, or a percutaneous approach, where a needle is used to puncture the vessel.
4. A guidewire is inserted into the artery, and a balloon catheter is advanced to the site of occlusion using the guidewire.
5. The provider confirms the position of the catheter using angiography and then inflates the balloon at the site of occlusion to expand the narrowed artery.
6. The provider ensures the restoration of blood supply using imaging guidance.
7. The catheter system is then withdrawn, and the puncture site is compressed or the incision is repaired.

4. Qualifying circumstances

CPT 37232 is used when the provider performs revascularization of each additional unilateral tibial or peroneal artery. This procedure is typically performed to treat arterial occlusion in patients with conditions such as peripheral artery disease. The provider may use an endovascular, open, or percutaneous approach, depending on the specific circumstances of the patient.

5. When to use CPT code 37232

CPT code 37232 should be used when the provider performs revascularization of each additional unilateral tibial or peroneal artery using transluminal angioplasty. This code is an add-on procedure and should be reported in addition to the primary procedure code for the initial vessel. It is important to ensure that the appropriate primary code is reported along with CPT 37232 to receive reimbursement from payers.

6. Documentation requirements

To support a claim for CPT 37232, the healthcare provider must document the following information:

• Specific details of the procedure performed, including the approach used (endovascular, open, or percutaneous)
• Number of additional vessels treated
• Confirmation of the occlusion and the site of the procedure
• Details of the transluminal angioplasty, including the use of a balloon catheter and the inflation of the balloon
• Imaging guidance used during the procedure
• Confirmation of the restoration of blood supply
• Documentation of any complications or additional interventions performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 37232, it is important to ensure that the appropriate primary procedure code is reported along with the add-on code. This code should not be reported without an appropriate primary code, such as CPT codes 37228, 37229, 37230, or 37231. Payers may not reimburse for CPT 37232 if it is reported without the primary code. It is also important to follow any specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT 37232 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 revascularization of each additional tibial artery using transluminal angioplasty to restore blood supply in a patient with peripheral artery disease.
2. Using an endovascular approach, a provider performs revascularization of each additional peroneal artery with transluminal angioplasty to treat arterial occlusion in a patient.
3. A healthcare provider uses a percutaneous approach to perform revascularization of each additional tibial artery using transluminal angioplasty in a patient with peripheral artery disease.