2025 CPT code 37247
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Cardiovascular System - Endovascular Revascularization Surgery Feed
Transluminal balloon angioplasty on each additional artery; add-on code.
Modifiers may apply depending on the circumstances of the procedure (e.g., 59 for distinctly separate procedures, 76 for repeat procedures, etc.).
Medical necessity is established by documented evidence of symptomatic arterial stenosis or occlusion.The documentation needs to clearly justify the need for transluminal balloon angioplasty, and show that the procedure is likely to alleviate symptoms and improve patient outcomes.This may include clinical findings, physiological data, and imaging results.
The clinical responsibility lies with the physician performing the transluminal balloon angioplasty.This includes patient preparation and anesthesia, catheter insertion and manipulation, balloon inflation/deflation, assessment of blood flow using angiography, and post-procedure care. The physician also oversees all imaging guidance and radiological supervision and interpretation.
In simple words: This code is for a procedure where a doctor uses a small balloon to open a blocked artery. If they have to open more than one artery during the same visit, this code is added to the main code (37246) for each extra artery that is treated. It doesn't apply to arteries in the legs, brain, heart, or lungs.
This CPT code, 37247, reports transluminal balloon angioplasty (TBA) on each additional artery treated during the same session. It is an add-on code and must be reported with a primary procedure code (37246) for the initial artery.This code includes all necessary imaging guidance, diagnostic imaging, and radiological supervision and interpretation (RS&I) for the additional artery.It is not reported for lower extremity, intracranial, coronary, pulmonary arteries, or the dialysis circuit. The procedure involves inserting a guiding catheter and guidewire, followed by advancing a balloon catheter to the blockage site.The balloon is inflated to compress plaque against the vessel wall, then deflated, potentially repeating this process until blood flow is satisfactory. The code is reported separately for each additional artery treated beyond the initial one.
Example 1: A patient presents with blockage in the right renal artery and the right common iliac artery.The physician performs a transluminal balloon angioplasty on the right renal artery (primary procedure, 37246), and then performs a transluminal balloon angioplasty on the right common iliac artery (additional procedure, 37247).37247 is reported separately., A patient undergoes a transluminal balloon angioplasty in the left internal carotid artery. During the procedure, the physician identifies and treats additional blockages in two branches of the same artery. The physician would report 37246 for the initial artery and 36218 or 36248 for each of the additional branches (instead of reporting 37247 for those branches)., A patient has blockages in both the left and right common carotid arteries. The physician performs separate transluminal balloon angioplasties for each artery. 37246 would be reported for the first artery, and a separate 37246 would be reported for the second artery.37247 would not be appropriate in this case because they are separate arteries and not additional arteries in the same family.
Pre-procedure documentation should include a comprehensive history and physical examination, including relevant imaging studies (e.g., angiograms).Intra-procedure documentation needs to detail the specific arteries treated, techniques used, balloon sizes, and the results of angiography, showing successful blood flow restoration. Post-procedure documentation should include any complications or findings.
** Always refer to the most current CPT codebook and payer-specific guidelines for the most accurate and up-to-date coding information.
- Revenue Code: P2D (Major Procedure, Cardiovascular - Coronary Angioplasty (PTCA))
- RVU: RVUs will vary based on geographic location and payer. Consult the appropriate fee schedule for specific values.
- Global Days: The global surgical period will vary based on the primary procedure and payer's guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code because it is considered a complete procedure.
- Fee Schedule: Historical fee schedule data is readily available from various sources but will vary by payer and geographic location.
- Specialties:Cardiology, Interventional Radiology, Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center