2025 CPT code 37799
(Active) Effective Date: N/A Surgery - Vascular Surgery Feed
Unlisted procedure, vascular surgery.
Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period), 59 (Distinct Procedural Service), 62 (Two Surgeons), 66 (Surgical Team), 78 (Return to the Operating Room for a Related Procedure during the Postoperative Period), and 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period) may be applicable. Refer to CPT guidelines for appropriate modifier usage.
Medical necessity must be clearly established for all procedures billed with 37799. Documentation must support the rationale for performing the unlisted procedure and demonstrate why no existing CPT code adequately describes the service provided.The clinical indications, treatment options considered, and the rationale for choosing the unlisted procedure must be well-documented in the patient's medical record.
In simple words: This code is used when a vascular surgeon performs a procedure that doesn't have its own specific code.
This code is used to report a vascular surgery procedure for which there is no specific code available.
Example 1: A patient presents with a complex vascular malformation that requires a novel surgical approach not described by any existing CPT code. The surgeon performs the procedure, and 37799 is reported along with detailed documentation., A patient undergoes a hybrid procedure involving both endovascular and open surgical techniques for a complex aneurysm repair. If no specific code exists for the combined procedure, 37799 may be used., During a vascular bypass procedure, the surgeon encounters unexpected intraoperative findings requiring an unplanned, innovative surgical technique.Due to the unique nature of the intervention, 37799 is reported with thorough documentation.
A detailed operative report outlining the procedure performed, including the approach, instruments used, and findings. Supporting documentation, such as pre- and postoperative diagnoses, imaging studies, and any other relevant medical records, should also be included.It is crucial to provide a comparison to a similar, existing CPT code to substantiate the billing amount and justify the medical necessity of the unlisted procedure. Always check with the specific payer for their documentation requirements, as they may have additional criteria.
** Always verify the latest coding guidelines and payer-specific policies before billing unlisted codes.Providing clear and comprehensive documentation is crucial for successful reimbursement.
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Interventional Radiology (in some cases)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center