2025 CPT code 37186
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Secondary percutaneous transluminal thrombectomy for removal of short thrombus segments in non-coronary arteries or bypass grafts, during other percutaneous interventions.
Modifiers 59 (distinct procedural service) may be appropriate in certain circumstances. Consult NCCI edits for specific guidance.
Medical necessity is established by documentation of acute limb ischemia or other symptoms attributable to the thrombus. The thrombectomy is performed to improve perfusion and prevent limb loss or other serious complications. The procedure must be medically necessary in relation to the patient's condition and cannot be considered elective.
The physician performs the thrombectomy under fluoroscopic guidance, potentially using mechanical devices or high-speed water jets to break up the clot.They may also administer thrombolytic injections to further dissolve the clot.Post-procedure evaluation is included.
In simple words: The doctor removes small blood clots from an artery in a leg or arm, or a bypass graft, while doing another procedure like placing a stent or balloon angioplasty. This is done using live X-ray guidance, and sometimes involves injecting clot-busting medicine.
This CPT code, 37186, reports secondary percutaneous transluminal thrombectomy.This procedure involves the removal or retrieval of short segments of thrombus or embolus from a non-coronary or non-intracranial artery, or from an arterial bypass graft.The thrombectomy is performed in conjunction with another percutaneous intervention, such as percutaneous transluminal angioplasty (PTA) or stent placement, either before or after. Fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections are included.This code should not be reported with 37184-37185.
Example 1: A patient undergoes a percutaneous transluminal angioplasty (PTA) for a femoral artery stenosis. During the procedure, a small thrombus is encountered. The physician performs a secondary mechanical thrombectomy (37186) to remove the thrombus before completing the PTA., A patient presents with an acutely occluded superficial femoral artery following a previous bypass graft.The physician uses a catheter-based approach to perform a mechanical thrombectomy (37186) to restore flow before proceeding to stent placement., A patient with a previously placed iliac artery stent presents with acute limb ischemia.Angiography reveals a thrombus within the stent.The physician performs mechanical thrombectomy (37186) to remove the thrombus from within the stent to improve flow before administering thrombolytics.
Pre-procedure angiography demonstrating the thrombus.Detailed operative report describing the technique of thrombectomy (mechanical or other).Intraoperative fluoroscopy images documenting the location and removal of the thrombus.Post-procedure angiography showing resolution of the thrombus and improved flow.Any thrombolytic agents used and their dosage.
** This code is specifically for the removal of short segments of thrombus or embolus that are encountered during other percutaneous procedures.It should not be used for primary mechanical thrombectomy.
- Revenue Code: P1G (Major Procedure - Other)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center