How To Use CPT Code 37234

CPT 37234 describes the revascularization procedure for 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 37234?

CPT 37234 is used to describe the revascularization procedure performed on an additional stenosed tibial or peroneal artery. The procedure can be done using an endovascular, open, or percutaneous approach. It involves the placement of a transluminal stent at the site of the occlusion to restore blood flow. This code also includes an angioplasty procedure if performed within the same vessel.

2. Official Description

The official description of CPT code 37234 is: ‘Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure).’ This code should be used in conjunction with codes 37229, 37230, or 37231.

3. Procedure

1. In this add-on procedure, the healthcare provider restores blood supply in an additional stenosed tibial or peroneal artery using an endovascular, open, or percutaneous approach.
2. The provider accesses the lumen of the diseased vessel through a puncture in the skin or an incision over the target artery.
3. A specially designed catheter stent system is then passed through a guidewire into the artery.
4. The provider places the stent at the site of the occlusion and expands it against the narrow portion of the vessel wall to open and recanalize the vessel.
5. An angioscope may be used to confirm the position of the stent.
6. After the procedure, the catheter system is withdrawn, and the puncture site is compressed or the incision is sutured to stop bleeding.

4. Qualifying circumstances

CPT 37234 is used when the provider performs revascularization on an additional stenosed tibial or peroneal artery. The procedure can be done using an endovascular, open, or percutaneous approach. It is important to note that this code should only be used in conjunction with primary codes 37229, 37230, or 37231.

5. When to use CPT code 37234

CPT code 37234 should be used when the provider performs revascularization on each additional stenosed tibial or peroneal artery. This code is appropriate when the procedure involves the placement of a transluminal stent and includes angioplasty within the same vessel. It is important to ensure that the primary procedure code is also reported in conjunction with CPT 37234.

6. Documentation requirements

To support a claim for CPT 37234, the provider must document the following information:

• Diagnosis indicating the need for revascularization
• Details of the procedure, including the approach used (endovascular, open, or percutaneous)
• Specific vessels treated
• Placement of transluminal stent(s)
• Angioplasty performed within the same vessel, if applicable
• Date of the procedure
• Signature of the healthcare provider

7. Billing guidelines

When billing for CPT 37234, it is important to ensure that the procedure is performed on each additional stenosed tibial or peroneal artery. This code should be reported in addition to the primary procedure code (37229, 37230, or 37231). Payers may not reimburse for CPT 37234 if it is reported without the appropriate primary code. It is also important to follow any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT code 37234 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 on an additional stenosed tibial artery using an endovascular approach and places a transluminal stent to restore blood flow.
2. Using a percutaneous approach, a provider performs revascularization on an additional stenosed peroneal artery and places a transluminal stent to open the vessel.
3. An open procedure is performed by a healthcare provider to revascularize an additional stenosed tibial artery and places a transluminal stent to recanalize the vessel.
4. A provider performs revascularization on an additional stenosed peroneal artery using an endovascular approach and performs angioplasty within the same vessel.