How To Use CPT Code 37619

CPT 37619 describes the ligation of the inferior vena cava, a surgical procedure that involves tying off the large vein that carries deoxygenated blood from the lower half of the body into the right atrium of the heart. This article will cover the description, official terminology, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37619?

CPT 37619 is a code used to describe the surgical procedure of ligation of the inferior vena cava. During this procedure, the provider ties off the inferior vena cava to narrow the diameter of the vessel using sutures or a clip. This is done to create an obstruction between the inferior vena cava and the pulmonary vein, preventing the movement of blood clots, or emboli, into the pulmonary vein.

2. Official Description

The official description of CPT code 37619 is: ‘Ligation of inferior vena cava.’ This code is used when the provider performs the surgical procedure of tying off the inferior vena cava to narrow its diameter and create an obstruction.

3. Procedure

1. The provider begins by making a midline abdomen incision, down through the muscles.
2. They then expose the inferior vena cava and place sutures around it or use a clip to cause partial obstruction.
3. This procedure is mainly done to prevent the movement of blood clots, or emboli, into the pulmonary vein.
4. After completing the ligation, the provider closes the incision in layers.

4. Qualifying circumstances

CPT 37619 is performed when there is a need to create an obstruction between the inferior vena cava and the pulmonary vein to prevent the movement of blood clots. This procedure is typically done for patients who are at risk of developing emboli, such as those with a history of deep vein thrombosis or pulmonary embolism. It is important to note that CPT 37619 should only be performed by a qualified healthcare professional with the necessary expertise and training in this specific procedure.

5. When to use CPT code 37619

CPT code 37619 should be used when the provider performs the ligation of the inferior vena cava to create an obstruction and prevent the movement of blood clots. It is important to ensure that this procedure is medically necessary and appropriate for the patient’s condition. The use of this code should be supported by the patient’s medical records and documentation.

6. Documentation requirements

To support a claim for CPT 37619, the provider must document the following information:

• Medical necessity for the procedure
• Details of the procedure performed, including the approach used (e.g., sutures or clip)
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 37619, it is important to ensure that the procedure was performed by a qualified healthcare professional and that it meets the necessary criteria for medical necessity. It is also important to follow any specific billing guidelines provided by the payer. CPT 37619 should not be reported with other codes unless there are additional procedures or services performed during the same operative session that are separately reportable.

8. Historical information

CPT 37619 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of deep vein thrombosis undergoes ligation of the inferior vena cava to prevent the movement of blood clots.
2. A provider performs ligation of the inferior vena cava during a surgical procedure to treat a pulmonary embolism.
3. A patient with a known clotting disorder undergoes ligation of the inferior vena cava as a preventive measure.
4. A provider performs ligation of the inferior vena cava to manage chronic venous insufficiency in a patient.
5. A patient with a large blood clot in the inferior vena cava undergoes ligation of the vessel to prevent the clot from traveling to the lungs.
6. A provider performs ligation of the inferior vena cava during a surgical procedure to treat a tumor that is compressing the vessel.
7. A patient with a history of recurrent pulmonary embolism undergoes ligation of the inferior vena cava to reduce the risk of future emboli.
8. A provider performs ligation of the inferior vena cava as part of a complex surgical procedure to treat a congenital heart defect.
9. A patient with a large blood clot in the inferior vena cava undergoes ligation of the vessel to prevent the clot from causing further complications.
10. A provider performs ligation of the inferior vena cava to manage chronic venous ulcers in a patient.