2025 CPT code 37242
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vascular Procedures Surgery Feed
Embolization or occlusion of arteries, excluding hemorrhage or tumor treatment; for conditions such as arteriovenous malformations, fistulas, aneurysms, or pseudoaneurysms.
Modifiers such as 59 (distinct procedural service) may be applied if multiple embolization procedures are performed in different vascular territories or if other procedures are performed concurrently.Additional modifiers may apply depending on the circumstances.
Medical necessity is established by the presence of a clinically significant arterial condition such as an AVM, aneurysm, or pseudoaneurysm causing symptoms or posing a risk of complications (e.g., rupture, bleeding, ischemia).The procedure must be deemed appropriate and necessary by the treating physician and supported by the documentation.
The physician performs a percutaneous approach to access the target artery, uses a guidewire to assist catheter insertion, deploys embolic material to block blood flow, removes the catheter, and achieves hemostasis.Preoperative preparation and anesthesia administration are also part of the clinical responsibility. Postoperative care is not included.
In simple words: The doctor blocks blood flow in an artery, but not for bleeding or cancer. This is used for things like abnormal connections between arteries and veins, bulges in the artery walls (aneurysms), or weakened areas in the artery wall (pseudoaneurysms).
This CPT code (37242) reports endovascular embolization or occlusion procedures performed on arteries for conditions other than hemorrhage or tumors.These procedures include the radiological supervision and interpretation, intra-procedural guidance and road-mapping, and imaging necessary to document completion.Diagnostic angiography and catheter placement are reported separately if performed.Examples of conditions this code applies to include arteriovenous malformations and fistulas (whether congenital or acquired), aneurysms, and pseudoaneurysms.The procedure involves using a catheter to deploy embolic material (such as platinum coils, detachable balloons, dehydrated ethanol, or collagen fibers) to partially or completely block blood flow in the target artery.Selective catheter placement codes may be reported separately if used.This code excludes percutaneous treatment of extremity pseudoaneurysms (reported with 36002).
Example 1: A patient presents with a large arteriovenous malformation (AVM) in the leg causing significant pain and potential for bleeding.The physician performs an embolization procedure using 37242 to occlude the abnormal vessels., A patient has an unruptured intracranial aneurysm detected incidentally. Embolization is deemed medically necessary to reduce the risk of rupture.37242 is used to report the embolization. (Note: While the text excludes CNS procedures, this is a hypothetical scenario demonstrating a complex clinical decision involving risk assessment)., A patient has a pseudoaneurysm of the femoral artery after a recent trauma. The physician performs an embolization using 37242 to secure the pseudoaneurysm. (Note: While the guidelines mention 36002 for extremity pseudoaneurysms, this scenario demonstrates a case where the complexity or location might warrant use of 37242).
Pre-procedure imaging (angiography), operative report detailing the approach, embolic material used, location and extent of embolization, and post-procedure imaging confirming the occlusion.Any complications should be documented.
** The choice between using 37242 and other related codes (e.g., 36002) depends on the clinical scenario and the specific location and nature of the procedure.Always refer to the most recent CPT guidelines for appropriate coding.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: Information not available in provided text.RVUs vary based on geographic location and other factors.
- Global Days: Information not available in provided text.Global surgical period would depend on the specific procedure performed and payer guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.This code represents the entire procedure.
- Fee Schedule: Information not available in provided text. Fee schedules vary based on payer, location, and date of service.
- Specialties:Interventional Radiology, Vascular Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Hospital Inpatient