2025 CPT code 37184
Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Primary percutaneous transluminal mechanical thrombectomy, non-coronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel.
Modifiers can be applied to 37184 to indicate specific circumstances, such as the use of modifiers 26 (professional component), TC (technical component), 59 (distinct procedural service), 76 (repeat procedure by same physician), 77 (repeat procedure by another physician) and others if applicable.
Medical necessity for 37184 must be supported by documentation demonstrating that the patient had an acute arterial occlusion or blockage in a non-coronary, non-intracranial artery or bypass graft, and that the procedure was necessary to restore blood flow and prevent serious complications like limb ischemia or organ damage.
The physician performing this procedure is responsible for prepping and anesthetizing the patient, accessing the artery, confirming the blockage (often with angiography), inserting the catheter, injecting heparin saline, identifying the clot location (sometimes using an angioscope), using fluoroscopy to guide the catheter and guidewire, injecting the thrombolytic agent, removing clot fragments, removing the catheter system, and controlling bleeding at the access site.
In simple words: This procedure removes a blood clot from an artery (not in the heart or brain) or a bypass graft using a small catheter inserted through the skin. The doctor uses imaging to guide the catheter and may also inject clot-busting medication. This code is for the first blood vessel treated during the procedure.
This code describes a procedure where a provider treats a blockage in a non-coronary, non-intracranial artery or arterial bypass graft.The procedure involves a combined technique of mechanical thrombectomy (physically removing or breaking up the clot) and injecting a thrombolytic agent (medication to dissolve the clot) under fluoroscopic guidance. This code is specifically for the initial vessel treated during the procedure.
Example 1: A patient presents with an acute lower limb ischemia due to a thromboembolism in the femoral artery.The physician performs a mechanical thrombectomy of the femoral artery using 37184., A patient with a history of peripheral artery disease has a blocked bypass graft in the leg. The surgeon performs a primary mechanical thrombectomy of the graft using 37184, followed by angioplasty to address the underlying stenosis., A patient develops a blood clot in the brachial artery. The physician uses a combination of mechanical thrombectomy and thrombolytic injection to clear the blockage, coding it as 37184.
Documentation should include details of the patient's condition necessitating the procedure, location of the blockage, method of access, use of fluoroscopic guidance, type of thrombolytic agent used, successful removal of the thrombus, and any complications encountered. Additionally, any other procedures performed during the same session, such as angioplasty or stent placement, should be clearly documented.
- RVU: The RVUs for this code can vary based on location and other factors. Refer to the Medicare Physician Fee Schedule (MPFS) for the most current and accurate RVU information. Check official resources like CMS or AMA for the latest information.
- Global Days: Refer to official resources like CMS or AMA for the latest information.
- Payment Status: Refer to relevant payer guidelines for current payment information.
- Modifier TC rule: Modifier TC might apply if the physician is billing only for the technical component of the procedure. Check payer-specific rules for guidance.
- Specialties:Interventional radiology, vascular surgery, cardiology (in some cases)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center