How To Use CPT Code 37235

CPT 37235 describes the revascularization procedure for the tibial/peroneal artery using endovascular, open, or percutaneous approaches. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37235?

CPT 37235 can be used to describe the revascularization procedure for the tibial/peroneal artery. This code is used when the provider restores the blood supply in each additional stenosed or narrowed unilateral tibial or peroneal artery through endovascular, open, or percutaneous approaches. The procedure may involve transluminal stent placement(s) and atherectomy, including angioplasty within the same vessel.

2. Official Description

The official description of CPT code 37235 is: ‘Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider assesses the patient’s condition and determines the need for revascularization of the tibial/peroneal artery.
2. The provider selects the appropriate approach, either endovascular, open, or percutaneous, based on the patient’s specific condition and circumstances.
3. If an open or percutaneous approach is chosen, the provider makes an incision or punctures the skin to access the occluded artery.
4. The provider performs transluminal stent placement(s) at the site of the occlusion, expanding the stent against the narrow portion of the vessel wall to restore blood flow.
5. The provider also performs an atherectomy, removing plaque from the blood vessel to further improve blood flow.
6. If necessary, the provider may also perform angioplasty within the same vessel during the procedure.
7. After completing the revascularization procedure, the provider closes the incision or puncture site and applies appropriate measures to stop bleeding and promote healing.

4. Qualifying circumstances

Patients eligible for CPT 37235 are those with additional stenosed or narrowed unilateral tibial or peroneal arteries requiring revascularization. The procedure is performed using endovascular, open, or percutaneous approaches. The provider may use transluminal stent placement(s) and atherectomy, including angioplasty within the same vessel if necessary.

5. When to use CPT code 37235

CPT code 37235 should be used when the provider performs revascularization of each additional stenosed or narrowed unilateral tibial or peroneal artery using endovascular, open, or percutaneous approaches. This code should be used in addition to the primary procedure code for the revascularization.

6. Documentation requirements

To support a claim for CPT 37235, the provider must document the following information:

• Patient’s diagnosis and the need for revascularization
• Specific approach used (endovascular, open, or percutaneous)
• Date and details of the procedure, including transluminal stent placement(s), atherectomy, and angioplasty if performed
• Location of the occlusion and the vessel(s) treated
• Any complications or additional interventions during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 37235, ensure that the procedure meets the criteria for each additional vessel revascularization using the specified approaches. It is important to report CPT 37235 in conjunction with the appropriate primary procedure code, such as 37231. Payers may not reimburse for CPT 37235 if it is reported without an appropriate primary code. Consider using modifiers if necessary to indicate any additional circumstances or complexities of the procedure.

8. Historical information

CPT 37235 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 of an additional stenosed tibial artery using an endovascular approach, including transluminal stent placement and atherectomy.
2. Using a percutaneous approach, a provider restores blood flow in an additional narrowed peroneal artery by performing transluminal stent placement and angioplasty within the same vessel.
3. An open approach is used by a provider to revascularize an additional stenosed tibial artery, performing transluminal stent placement and atherectomy.
4. Using an endovascular approach, a provider performs revascularization of an additional narrowed peroneal artery, including transluminal stent placement and angioplasty within the same vessel.
5. A provider restores blood flow in an additional stenosed tibial artery using a percutaneous approach, performing transluminal stent placement and atherectomy.
6. Using an open approach, a provider revascularizes an additional narrowed peroneal artery, performing transluminal stent placement and angioplasty within the same vessel.