How To Use CPT Code 37253

CPT 37253 describes the use of intravascular ultrasound (IVUS) during diagnostic evaluation and/or therapeutic intervention for noncoronary vessels. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37253?

CPT 37253 is used to report the use of intravascular ultrasound (IVUS) during diagnostic evaluation and/or therapeutic intervention for noncoronary vessels. This code is an add-on procedure and should be reported in addition to the primary procedure code. It is important to note that CPT 37253 should only be reported if the provider has performed IVUS for an additional noncoronary vessel after the first.

2. Official Description

The official description of CPT code 37253 is: ‘Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 37252 for the initial noncoronary vessel.

3. Procedure

1. The provider begins by making a small incision in the skin over the noncoronary vessel.
2. An introducer sheath is inserted into the vessel to provide access for the ultrasound catheter.
3. A guide wire is then placed through the sheath and into the vessel.
4. The provider inserts the ultrasound catheter over the guide wire and advances it into the vessel.
5. The catheter emits high-frequency sound waves and records the echoes to create images of the vessel’s interior.
6. The provider uses these images to evaluate the vessel and guide any necessary therapeutic interventions.
7. Once the procedure is complete, the catheter and guide wire are removed, and the provider closes the incision.

4. Qualifying circumstances

CPT 37253 is used when the provider performs intravascular ultrasound for each additional noncoronary vessel after the first. This code is applicable for both diagnostic evaluation and therapeutic intervention procedures. It is important to note that radiological supervision and interpretation are included in this code.

5. When to use CPT code 37253

CPT code 37253 should be used when the provider performs intravascular ultrasound for each additional noncoronary vessel after the first. This code should only be reported in conjunction with the primary procedure code and should not be reported without an appropriate primary code. It is essential to review the documentation and determine if the use of IVUS for additional noncoronary vessels is necessary before reporting this code.

6. Documentation requirements

To support a claim for CPT 37253, the provider must document the following information:

• Indication for the use of intravascular ultrasound
• Specific noncoronary vessel(s) evaluated or treated
• Date of the procedure
• Start and end times of the procedure
• Details of the therapeutic intervention, if applicable
• Radiological supervision and interpretation
• Signature of the provider

7. Billing guidelines

When billing for CPT 37253, ensure that the provider has performed intravascular ultrasound for each additional noncoronary vessel after the first. This code should be reported in addition to the primary procedure code. It is important to note that some payers may consider intravascular ultrasound of noncoronary vessels investigational and may not provide coverage. It is recommended to check with the Medicare provider or private carrier to determine their policies.

8. Historical information

CPT 37253 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A provider performs intravascular ultrasound for an additional noncoronary vessel during a diagnostic evaluation for peripheral artery disease.
2. During a therapeutic intervention for a renal artery stenosis, the provider utilizes intravascular ultrasound for each additional noncoronary vessel.
3. In a procedure to treat an abdominal aortic aneurysm, the provider performs intravascular ultrasound for each additional noncoronary vessel.
4. A patient undergoes a diagnostic evaluation for carotid artery disease, and the provider uses intravascular ultrasound for an additional noncoronary vessel.
5. During a therapeutic intervention for an iliac artery occlusion, the provider utilizes intravascular ultrasound for each additional noncoronary vessel.
6. In a procedure to treat a femoral artery aneurysm, the provider performs intravascular ultrasound for an additional noncoronary vessel.
7. A patient undergoes a diagnostic evaluation for mesenteric artery disease, and the provider uses intravascular ultrasound for each additional noncoronary vessel.
8. During a therapeutic intervention for a popliteal artery stenosis, the provider utilizes intravascular ultrasound for an additional noncoronary vessel.
9. In a procedure to treat a subclavian artery occlusion, the provider performs intravascular ultrasound for each additional noncoronary vessel.
10. A patient undergoes a diagnostic evaluation for renal artery stenosis, and the provider uses intravascular ultrasound for an additional noncoronary vessel.