How To Use CPT Code 37249

CPT 37249 describes the procedure of transluminal balloon angioplasty performed on additional veins, following the initial vein, using a balloon placed through a catheter. 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 37249?

CPT 37249 is used to describe the procedure of transluminal balloon angioplasty performed on additional veins, following the initial vein. This procedure involves the use of a balloon placed through a catheter to open up the vein and improve blood circulation. The provider may perform this procedure multiple times and at multiple points within the same vein. It includes all necessary imaging guidance and radiological supervision and interpretation.

2. Official Description

The official description of CPT code 37249 is: ‘Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 37248 for the initial vein.

3. Procedure

1. After performing transluminal balloon angioplasty on the initial vein, the provider inserts a needle into another vein.
2. A guide wire is placed through the needle and the needle is removed.
3. An introducer is threaded over the guide wire and advanced to the area of blockage.
4. The provider may use imaging guidance, such as fluoroscopy or ultrasound, to assist in the procedure.
5. A contrast dye may be injected into the vessel to visualize blood flow and identify areas that need to be angioplastied.
6. The balloon at the tip of the catheter is inflated to dilate the vein and press the material causing the blockage against the vessel wall.
7. The balloon is deflated and the procedure may be repeated at other points along the vessel to address all areas of blockage or narrowing.
8. Angiography with contrast injections may be used to assess blood flow and determine the success of the procedure.
9. Once the vein is open and blood flow is satisfactory, the catheter is removed and the procedure is completed.

4. Qualifying circumstances

CPT 37249 is performed on patients who require transluminal balloon angioplasty on additional veins, following the initial vein. This procedure is typically performed on patients with occlusive disease in the iliac, femoral, popliteal, or tibial/peroneal arteries. It should not be reported in conjunction with other codes for angioplasty in the same vein during the same operative session or within specific segments of the femoral-popliteal or tibial-peroneal arteries.

5. When to use CPT code 37249

CPT code 37249 should be used when the provider performs transluminal balloon angioplasty on additional veins, following the initial vein. It should be reported separately in addition to the primary procedure code (CPT code 37248). This code should not be reported with other codes for angioplasty in the same vein during the same operative session or within specific segments of the femoral-popliteal or tibial-peroneal arteries.

6. Documentation requirements

To support a claim for CPT code 37249, the provider must document the following information:

• Indication for the procedure and the need for transluminal balloon angioplasty on additional veins
• Details of the procedure, including the number of additional veins treated
• Date of the procedure
• Imaging guidance used, if applicable
• Contrast dye injection and angiography findings, if applicable
• Assessment of blood flow and success of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 37249, ensure that the procedure is performed on additional veins following the initial vein. It should be reported in conjunction with CPT code 37248 for the initial vein. Do not report CPT code 37249 with other codes for angioplasty in the same vein during the same operative session or within specific segments of the femoral-popliteal or tibial-peroneal arteries.

8. Historical information

CPT code 37249 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes transluminal balloon angioplasty on the initial vein, followed by angioplasty on two additional veins using CPT code 37249.
2. After performing transluminal balloon angioplasty on the initial vein, the provider performs angioplasty on three additional veins using CPT code 37249.
3. Transluminal balloon angioplasty is performed on the initial vein, followed by angioplasty on four additional veins using CPT code 37249.
4. A patient undergoes transluminal balloon angioplasty on the initial vein, followed by angioplasty on five additional veins using CPT code 37249.