How To Use CPT Code 61635

CPT 61635 describes the procedure for the transcatheter placement of intravascular stent(s) in the intracranial region, including balloon angioplasty if necessary. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61635?

CPT 61635 can be used to describe the procedure of placing intravascular stents in the intracranial region, specifically for treating atherosclerotic stenosis. This code includes the use of balloon angioplasty if required. It is important to note that CPT 61635 encompasses all selective vascular catheterization, diagnostic imaging for arteriography, and related radiological supervision and interpretation for the target vascular territory.

2. Official Description

The official description of CPT code 61635 is: ‘Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed.’

3. Procedure

1. To perform CPT 61635, the provider begins by inserting a catheter into an artery, typically the femoral artery in the groin, using percutaneous access.
2. The provider then advances the catheter through the bloodstream to the site in the brain where the stenotic, plaque-narrowed artery is located.
3. If necessary, the provider may inflate a small balloon within the narrowed artery to dilate it and reduce the narrowing.
4. Finally, the provider places a self-expanding mesh-like tube called a stent over the plaque to hold the artery open.

4. Qualifying circumstances

CPT 61635 is used for patients with intracranial atherosclerotic stenosis who require the placement of intravascular stents. The procedure is performed by a provider who has the necessary expertise and qualifications. It is important to note that CPT 61635 includes all selective vascular catheterization, diagnostic imaging for arteriography, and related radiological supervision and interpretation for the target vascular territory.

5. When to use CPT code 61635

CPT code 61635 should be used when a provider performs the transcatheter placement of intravascular stents in the intracranial region, specifically for treating atherosclerotic stenosis. This code should be reported for each vessel in which the stent placement is performed. It is important to note that CPT 61635 should not be reported in conjunction with CPT 61645 for the same vascular territory.

6. Documentation requirements

To support a claim for CPT 61635, the provider must document the following information:

• Patient’s diagnosis and the need for intravascular stent placement
• Details of the procedure, including the specific vessels involved
• Date of the procedure
• Any additional procedures performed, such as balloon angioplasty
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 61635, ensure that the procedure is performed by a qualified provider and that all necessary components, such as selective catheterization and imaging, are included. It is important to note that CPT 61635 includes all selective vascular catheterization, diagnostic imaging for arteriography, and related radiological supervision and interpretation for the target vascular territory. Therefore, these services should not be reported separately. Additionally, CPT 61630 should not be reported together with CPT 61635 for the same vessel.

8. Historical information

CPT 61635 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition. It is worth noting that CPT 61635 was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs the transcatheter placement of intravascular stents in the intracranial region for a patient with atherosclerotic stenosis in the middle cerebral artery.
2. During the procedure, the provider also performs balloon angioplasty to further dilate the narrowed artery.
3. Another provider performs the transcatheter placement of intravascular stents in the intracranial region for a patient with atherosclerotic stenosis in the basilar artery.
4. The procedure is successful in improving blood flow to the brain and reducing the risk of stroke for the patient.
5. A different provider performs the transcatheter placement of intravascular stents in the intracranial region for a patient with atherosclerotic stenosis in multiple vessels, including the anterior cerebral artery and the posterior cerebral artery.
6. The provider carefully selects the appropriate stents for each vessel and ensures their proper placement.
7. After the procedure, the patient experiences improved blood flow and a reduced risk of stroke.
8. Another provider performs the transcatheter placement of intravascular stents in the intracranial region for a patient with atherosclerotic stenosis in the internal carotid artery.
9. The provider also performs balloon angioplasty to further open the narrowed artery and improve blood flow.