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2025 CPT code 37218

Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation.

This code includes all ipsilateral extracranial intrathoracic selective innominate and carotid catheterization, all diagnostic imaging for ipsilateral extracranial intrathoracic innominate and/or carotid artery stenting, and all related radiologic supervision and interpretation.Report 37218 when the ipsilateral extracranial intrathoracic carotid arteriogram confirms the need for stenting. If stenting is not indicated, report the appropriate codes for selective catheterization and imaging.

Modifiers may be applicable in certain situations (e.g., 50 for bilateral procedures, 59 for distinct procedural service).

Medical necessity must be established by documenting the patient's symptoms, diagnostic findings (e.g., angiography results), and the clinical rationale for performing the stent placement.

The physician is responsible for prepping and anesthetizing the patient, accessing the target vessel via open or percutaneous approach, navigating a catheter to the treatment site using fluoroscopic guidance, performing angioplasty (if necessary), deploying the stent, achieving hemostasis, and closing the incision (if applicable).

IMPORTANT:Do not report 37218 in conjunction with 36222, 36223, or 36224 for the treated carotid artery. For open or percutaneous transcatheter placement of intravascular cervical carotid artery stent(s), see 37215, 37216. For open or percutaneous transcatheter placement of extracranial vertebral artery stent(s), see 0075T, 0076T. For transcatheter placement of intracranial stent(s), use 61635.

In simple words: This procedure involves placing a small, expandable tube called a stent into an artery in the upper chest to keep it open. The doctor uses a thin tube called a catheter to reach the artery, and may also use a balloon to widen the artery before placing the stent.X-ray imaging is used to guide the procedure. This is done to improve blood flow to the head and neck.

This code describes a procedure where a physician places one or more stents within the intrathoracic common carotid artery or the innominate artery using a catheter. The approach can be either open (requiring an incision) or percutaneous (through the skin).The procedure includes angioplasty, if performed, and radiological supervision and interpretation are included. The approach is specifically antegrade, meaning it follows the normal direction of blood flow.

Example 1: A patient with a severely narrowed intrathoracic common carotid artery undergoes a percutaneous antegrade stent placement procedure with angioplasty to improve blood flow to the brain., A patient with a blockage in the innominate artery requires an open antegrade approach for stent placement to relieve symptoms of decreased blood flow to the right arm and right side of the head., Following a diagnostic angiogram revealing a stenosis in the intrathoracic left common carotid artery, a patient undergoes stent placement via an antegrade approach to prevent stroke.

Documentation should include details of the approach (open or percutaneous), the target vessel (intrathoracic common carotid or innominate artery), use of angioplasty (if performed), confirmation of stent placement, and any complications encountered.

** Code 37218 includes distal embolic protection when performed.

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