2025 CPT code 37185
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Add-on code for percutaneous transluminal mechanical thrombectomy of second and subsequent vessels within the same noncoronary, non-intracranial vascular family.
Modifiers 50 (bilateral procedure) and 59 (distinct procedural service) may be applicable in certain circumstances, as dictated by the specific clinical scenario.
Medical necessity is established by documentation of acute or chronic arterial occlusion(s) compromising perfusion to a limb or organ. Imaging studies (angiography) must demonstrate the occlusion(s) and the need for intervention. The medical necessity for treating multiple vessels within the same family is supported by the clinical presentation and the risk of further ischemia if only the initial vessel is treated.
The clinical responsibility involves accessing and treating subsequent arteries or bypass grafts within the same vascular family following the treatment of an initial vessel using mechanical thrombectomy and thrombolytic injection. This includes arterial puncture, catheter insertion, irrigation, clot identification, guidewire insertion, catheter advancement, thrombolytic injection, clot fragment removal, and hemostasis.
In simple words: This code describes an additional procedure to clear blockages in arteries or bypass grafts.It's only used if a doctor already used the same method to clear a blockage in a different artery in the same area and is an addition to the main procedure code.
This CPT code 37185 reports the add-on procedure for percutaneous transluminal mechanical thrombectomy of the second and all subsequent arteries or arterial bypass grafts within the same noncoronary, non-intracranial vascular family.The procedure includes fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s). This code is only reported in addition to the primary mechanical thrombectomy code (37184) for the initial vessel treated within the same vascular family.It should not be used independently.
Example 1: A patient presents with acute limb ischemia due to thrombi in the femoral and popliteal arteries.The physician performs mechanical thrombectomy of the femoral artery (37184) followed by thrombectomy of the popliteal artery (37185)., A patient has multiple arterial bypass grafts with occlusions. The physician performs mechanical thrombectomy on the initial graft (37184), followed by thrombectomy on two subsequent grafts within the same vascular family (37185 x2)., A patient presents with a thrombosed arteriovenous fistula.The physician accesses the fistula and performs mechanical thrombectomy (37184) and subsequently clears additional thrombi in the same fistula using the add-on code (37185).
Detailed operative report specifying the vessels treated, techniques used (mechanical thrombectomy and thrombolytic injection), fluoroscopy use, and the reason for multiple vessel treatment. Pre- and post-procedure angiograms demonstrating the occlusion and restoration of blood flow are essential.Documentation should clearly indicate the initial vessel treated with 37184 and the subsequent vessels addressed with 37185.
** Careful consideration of the vascular family and the relationship between the initial and subsequent vessels treated is crucial for accurate coding.Consult the most current CPT manual and NCCI edits for the most up-to-date information.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center