How To Use CPT Code 37650

CPT 37650 describes the ligation of the femoral vein, a procedure commonly performed to address varicose veins. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37650?

CPT 37650 is used to describe the ligation of the femoral vein, a procedure in which the provider makes an incision in the upper leg to access the femoral vein and ligates it using sutures or a clip. This procedure is typically performed to address varicose veins, which are swollen and twisted veins that can cause pain, discoloration of the skin, and ulcers.

2. Official Description

The official description of CPT code 37650 is: ‘Ligation of femoral vein.’ If the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. To perform the ligation of the femoral vein, the provider begins by making a small incision in the upper leg over the affected femoral vein.
2. Next, the provider incises through the muscles and gains access to the vein.
3. Under direct visualization, the provider separates the vein from nearby structures and ligates it using a venous clip or by placing sutures around the vein.
4. After the ligation, the provider secures the vein back to its original position and sutures the surgical wound in layers.

4. Qualifying circumstances

CPT 37650 is typically performed for patients with varicose veins, which are caused by the failure of valves in the vein that allow blood to flow in the reverse direction. The procedure is performed by a provider to address the symptoms associated with varicose veins, such as pain, discoloration of the skin, and ulcers.

5. When to use CPT code 37650

CPT code 37650 should be used when the provider performs the ligation of the femoral vein to address varicose veins. It is important to note that this code should not be reported if the ligation of the femoral vein is included as a component of a more comprehensive procedure, such as control of bleeding in a specific area.

6. Documentation requirements

To support a claim for CPT 37650, the provider must document the following information:

• Patient’s diagnosis of varicose veins
• Details of the procedure, including the incision site and method of ligation
• Date of the procedure
• Any additional relevant information, such as the use of a venous clip or sutures

7. Billing guidelines

When billing for CPT 37650, ensure that the procedure is performed to address varicose veins. It is important to review the documentation and confirm that the ligation of the femoral vein is not included as a component of another procedure. Modifier 50 should be appended to the code if the procedure is performed bilaterally.

8. Historical information

CPT 37650 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs the ligation of the femoral vein to address varicose veins in a patient’s left leg.
2. A patient undergoes the ligation of the femoral vein as part of a comprehensive procedure to control bleeding in the femoral vein area.
3. A provider performs the ligation of the femoral vein bilaterally to address severe varicose veins in both legs.
4. A patient with varicose veins undergoes the ligation of the femoral vein, followed by excision of the affected vein.
5. A provider performs the ligation, division, and stripping of the great saphenous vein, along with the ligation of the femoral vein, to address varicose veins in a patient’s leg.
6. A patient undergoes the ligation of the femoral vein to address the symptoms associated with varicose veins, such as pain and discoloration of the skin.
7. A provider performs the ligation of the femoral vein, followed by a skin graft, to address an ulcer caused by varicose veins.
8. A patient with varicose veins undergoes the ligation, division, and stripping of the great saphenous vein, as well as the ligation of the femoral vein, to address the condition.
9. A provider performs the ligation of the femoral vein to address varicose veins in a patient’s leg, using a venous clip for the ligation.
10. A patient undergoes the ligation of the femoral vein as part of a comprehensive procedure to address complications associated with varicose veins.