2025 CPT code 37187
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vascular Procedures Surgery Feed
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance.
Modifiers 50 (bilateral procedure) and 59 (distinct procedural service) may be applicable. Consult current CPT guidelines and NCCI edits for appropriate modifier use.
Medical necessity for venous thrombectomy is established when the patient presents with symptoms consistent with venous thromboembolism and diagnostic imaging confirms the presence of an obstructing thrombus that is causing significant clinical compromise (e.g., limb ischemia, pulmonary embolism).
The physician's responsibility includes accessing the vein, performing venography (if necessary), inserting the guidewire and catheter, mechanically fragmenting the clot, administering thrombolytic agents, removing instruments, and ensuring hemostasis.
In simple words: This procedure removes a blood clot from a vein. A small incision is made, and a thin tube is guided to the clot. A tool breaks up the clot, and medicine dissolves it.X-rays are used to guide the procedure.
This CPT code encompasses percutaneous transluminal mechanical thrombectomy of one or more veins, incorporating intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance.The procedure involves accessing the affected vein(s), typically the femoral or popliteal vein, via a small incision.Venography (contrast injection) may be performed to precisely locate the clot. A guidewire and catheter are advanced to the occlusion site. The thrombus is then mechanically fragmented using a device at the catheter tip (e.g., a blade or high-speed water jet) and further dissolved with thrombolytic injections.All instruments are removed, and hemostasis is achieved.
Example 1: A 65-year-old patient presents with deep vein thrombosis (DVT) in the left femoral vein.The physician performs a percutaneous transluminal mechanical thrombectomy of the left femoral vein, including intraprocedural thrombolytic injections and fluoroscopic guidance using code 37187., A 70-year-old patient with a history of atrial fibrillation develops a pulmonary embolism.The physician performs a percutaneous transluminal mechanical thrombectomy of the iliac vein and femoral vein, requiring two separate access sites.Code 37187 is used with modifier 50 to bill for the bilateral procedure., A 50-year-old patient presents with acute iliofemoral venous thrombosis. Initial mechanical thrombectomy is performed using 37187.The patient is readmitted the following day for continued clot resolution; code 37188 would be used for the subsequent day.
* Thorough history and physical examination documenting the indication for thrombectomy.* Diagnostic imaging (e.g., ultrasound, venography) confirming the presence and location of the thrombus.* Operative report detailing the technique used, including type of catheter and device used for mechanical thrombectomy, and type and amount of thrombolytic agent administered.* Documentation of any complications or adverse events.* Post-procedure imaging (if performed) to assess the effectiveness of the procedure.
** The information provided is based on the CPT guidelines and may not encompass all aspects of coding for this procedure.Always refer to the most current CPT manual and payer-specific guidelines for accurate coding and billing.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided text and would require access to a current relative value unit database.
- Global Days: The global period for this procedure is not explicitly defined in the source.Further clarification is needed from the official CPT guidelines or a billing resource.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Fee Schedule: Historical fee schedule data is not available in the provided text and would require accessing a historical fee database.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center