How To Use CPT Code 61642

CPT 61642 describes the percutaneous balloon dilatation of intracranial vasospasm in a different vascular territory from the initial vessel. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 61642?

CPT 61642 can be used to describe the percutaneous balloon dilatation of intracranial vasospasm in a different vascular territory from the initial vessel. This code is used when the provider performs additional intracranial angioplasty and balloon dilatation to widen another intracranial vessel in a different vascular territory.

2. Official Description

The official description of CPT code 61642 is: ‘Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure).’ Notes: (Use 61641 and 61642 in conjunction with 61640) (61640, 61641, 61642 include all selective vascular catheterization of the target vessel, contrast injection[s], vessel measurement, roadmapping, postdilatation angiography, and fluoroscopic guidance for the balloon dilatation) (Do not report 61640, 61642 in conjunction with 61650 or 61651 for the same vascular territory) (For definition of vascular territory, see the Nervous System Endovascular Therapy guidelines).

3. Procedure

1. The provider obtains diagnostic angiograms to confirm the location of the narrowed vessels.
2. Intravenous heparin is administered to prevent clots before and during the procedure.
3. The provider performs the initial balloon dilatation of the vasospastic vessel.
4. The provider repositions the catheter and guidewire to treat another intracranial vessel in a different vascular territory.
5. The provider measures the additional stenotic artery to determine the proper diameter and length of the angioplasty balloon.
6. The provider advances the balloon over the guidewire to the stenotic site and inflates it to dilate the lesion.
7. The provider confirms dilatation of the vessels through contrast injection and performs angiograms to check for restenosis or arterial blockage.
8. If restenosis is present, the provider redilates the lesion with a larger balloon if necessary.
9. The provider removes the balloon and guidewire and takes final angiograms to check for complications.