How To Use CPT Code 37761

CPT 37761 describes the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, when performed, on one leg. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 37761?

CPT 37761 can be used to describe the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, when performed, on one leg. This code is used when the provider makes incisions along the affected vein and accesses the targeted perforator vein, which connects the superficial vein to the deep veins. The provider then ligates the vein to treat varicose veins, performing the procedure with the assistance of ultrasound guidance.

2. Official Description

The official description of CPT code 37761 is: ‘Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg.’

3. Procedure

1. The provider makes incisions along the affected vein and accesses the targeted perforator vein using ultrasound guidance.
2. The provider incises through the fascia and excises nearby diseased structures.
3. The provider ligates the perforator vein with a suture or clip.
4. The provider secures the ligated vein inside the fascia and sutures the fascia covering around it.
5. The provider sutures the wounds in layers.
6. If necessary, the provider may repeat the procedure on other veins of the same leg.

4. Qualifying circumstances

Patients eligible to receive CPT 37761 services are those with varicose veins that require ligation of perforator vein(s). The procedure is performed on one leg. The provider must use an open procedure and perform the ligation under ultrasound guidance.

5. When to use CPT code 37761

CPT code 37761 should be used when the provider performs the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, on one leg. This code should only be reported once for one leg. If the procedure is performed on both legs, the appropriate modifier should be used to indicate a bilateral procedure.

6. Documentation requirements

To support a claim for CPT 37761, the provider must document the following information:

• Indication for the ligation of perforator vein(s)
• Use of ultrasound guidance during the procedure
• Details of the incisions made and access to the targeted perforator vein
• Method of ligation (suture or clip)
• Any excision of nearby diseased structures
• Securing of the ligated vein inside the fascia
• Suturing of the fascia covering and wounds
• Any additional procedures performed on other veins of the same leg

7. Billing guidelines

When billing for CPT 37761, ensure that the procedure is performed on one leg using an open technique and includes ultrasound guidance, when performed. If the procedure is performed on both legs, the appropriate modifier should be used to indicate a bilateral procedure. Do not report CPT 37761 in conjunction with other codes specified in the notes. Ultrasound guidance should not be reported separately.

8. Historical information

CPT 37761 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A surgeon performing the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, on one leg to treat varicose veins.
2. An interventional radiologist using ultrasound guidance to ligate a perforator vein in a patient with varicose veins.
3. A vascular surgeon performing the ligation of a perforator vein using an open procedure and ultrasound guidance to alleviate symptoms of venous insufficiency.
4. A general surgeon performing the ligation of perforator vein(s) on one leg using an open technique and ultrasound guidance to improve blood flow and reduce swelling in a patient with varicose veins.
5. An interventional cardiologist using ultrasound guidance to perform the ligation of a perforator vein in a patient with chronic venous insufficiency.
6. A vascular surgeon performing the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, on one leg to alleviate pain and improve circulation in a patient with varicose veins.
7. An interventional radiologist using ultrasound guidance to ligate a perforator vein in a patient with venous ulcers.
8. A general surgeon performing the ligation of a perforator vein using an open procedure and ultrasound guidance to treat a patient with recurrent varicose veins.
9. An interventional cardiologist using ultrasound guidance to perform the ligation of a perforator vein in a patient with deep vein thrombosis.
10. A vascular surgeon performing the ligation of perforator vein(s) using an open procedure, including ultrasound guidance, on one leg to improve venous circulation in a patient with leg swelling.