How To Use CPT Code 37500

CPT 37500 describes a surgical procedure known as vascular endoscopy with ligation of perforator veins, subfascial (SEPS). 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 37500?

CPT 37500 is a code used to describe a surgical procedure called vascular endoscopy with ligation of perforator veins, subfascial (SEPS). This procedure involves the placement of an endoscope by a healthcare provider to remove or separate superficial veins that are perforating through the fascia and connecting to the deep veins. It is typically performed to treat venous ulcers and improve circulation.

2. Official Description

The official description of CPT code 37500 is: ‘Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS).’ This code is used for the surgical procedure that involves the use of an endoscope to identify and detach perforated veins below the fascia, followed by ligation or transection of the veins.

3. Procedure

1. When performing CPT 37500, the healthcare provider begins by making a small incision over the affected area, usually the calf, and introduces a balloon catheter to keep the area open for access during the procedure.
2. Two additional stab incisions are made to provide port entry for the endoscope.
3. Using the endoscope, the provider identifies the perforated veins below the fascia and detaches them from the surface of the fascia.
4. The provider then either ties off or transects the perforated veins to prevent further blood flow through them.
5. After completing the procedure, the provider removes the endoscope, irrigates the incisions, and sutures them as necessary.
6. The patient may be provided with elastic stockings to wear, which help apply pressure and aid in the healing process of the leg.

4. Qualifying circumstances

CPT 37500 is typically performed on patients with venous ulcers or other conditions that require the detachment of abnormally perforated veins to improve circulation. The procedure is performed by a healthcare provider who is trained in vascular endoscopy and has the necessary expertise to perform the ligation of perforator veins subfascially. It is important to note that this procedure is specifically for subfascial ligation and should not be confused with open procedures, which have a different CPT code (37760).

5. When to use CPT code 37500

CPT code 37500 should be used when a healthcare provider performs the surgical procedure of vascular endoscopy with ligation of perforator veins, subfascial (SEPS). It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code. If the procedure does not involve the subfascial ligation of perforator veins, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 37500, the healthcare provider must document the following information:

• Patient’s diagnosis and the medical necessity for the procedure
• Details of the procedure performed, including the use of an endoscope, ligation or transection of perforator veins, and any other relevant details
• Date of the procedure
• Incision sites and any sutures or closures made
• Post-procedure instructions given to the patient, such as the use of elastic stockings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 37500, it is important to ensure that the procedure meets the specific criteria outlined in the official description. The procedure should be reported with CPT code 37500 and should not be reported with other codes unless there are additional procedures performed that meet the criteria for separate reporting. It is important to follow the guidelines provided by the payer and ensure accurate documentation to support the billing of CPT 37500.

8. Historical information

CPT code 37500 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs vascular endoscopy with ligation of perforator veins, subfascial (SEPS) on a patient with venous ulcers in their calf.
2. During the procedure, the provider uses an endoscope to identify and detach the perforated veins below the fascia, followed by ligation to improve circulation.
3. Another patient undergoes vascular endoscopy with ligation of perforator veins, subfascial (SEPS) to treat their chronic venous insufficiency.