2025 CPT code 37188
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Vascular Surgery Surgery Feed
Repeat venous mechanical thrombectomy on a subsequent day during thrombolytic therapy.
Modifiers 50 (bilateral procedure) may be applicable depending on the clinical scenario.
Medical necessity is established when the patient exhibits persistent or recurrent venous occlusion despite initial treatment, necessitating further thrombectomy and thrombolytic therapy.Supporting documentation should demonstrate the presence of residual clot and the clinical rationale for the repeat procedure.
The physician is responsible for accessing the vein, performing venography, inserting a guidewire and catheter, using mechanical thrombectomy to break up the clot, administering thrombolytic medication, and ensuring hemostasis.
In simple words: This procedure is a repeat treatment to remove a blood clot from a vein.It uses special tools to break up the clot and medicine to dissolve it. This happens on a day after the first treatment.
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on a subsequent day during a course of thrombolytic therapy. This code represents the repeat treatment for venous occlusion using a combined mechanical and thrombolytic approach on a day after the initial treatment.
Example 1: A patient presents with a deep vein thrombosis (DVT) in the femoral vein.After an initial treatment with 37187, the clot is not completely removed. 37188 is used for the subsequent day's treatment., A patient with a history of atrial fibrillation develops a pulmonary embolism.After initial thrombectomy and thrombolytic therapy (37187), further thrombectomy is necessary on the following day. Code 37188 is used., A patient with a recurrent DVT in the popliteal vein requires a repeat procedure to remove residual clot. Initial treatment was done with 37187;this second-day procedure is coded as 37188.
Detailed notes documenting the initial procedure (37187), the indication for a repeat procedure (residual clot), the date and time of the second procedure, the approach used (percutaneous), the type of mechanical thrombectomy device used, the amount and type of thrombolytic agent administered, and the post-procedure evaluation. Imaging studies (before and after) are also essential.
** The provided text mentions fluoroscopic guidance as an included service.Ensure all components of the procedure are performed to justify coding.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Not available in provided text.
- Global Days: Not specified in provided text.Requires further clarification from official CPT guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided text.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center