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2025 CPT code 37232

Add-on code for each additional unilateral tibial or peroneal artery revascularization using transluminal angioplasty.

Always use this code as an add-on code with codes 37228-37231.The number of units reported should correspond to the number of additional vessels treated. Follow CPT guidelines for reporting.

Modifiers may apply depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services).Consult payer-specific guidelines.

Medical necessity is established by demonstrating symptomatic peripheral artery disease or critical limb ischemia with objective evidence of arterial occlusion in the tibial or peroneal arteries affecting blood flow and necessitating revascularization. Documentation must support the need for each additional procedure.

The physician is responsible for performing the revascularization procedure, including the selection of approach (endovascular, open, or percutaneous), catheterization, balloon angioplasty, and ensuring adequate blood flow restoration.Post-procedure monitoring and follow-up care may also fall under the physician’s responsibility.

IMPORTANT:This code is always used in addition to codes 37228-37231 (initial vessel revascularization).

In simple words: This code is for an extra procedure to improve blood flow in a leg artery. It's only used if a doctor has already done the same procedure on one leg artery and now needs to do it on another artery in the same leg.The doctor uses a tiny balloon to open up the blocked artery.

This CPT code, 37232, is an add-on code representing endovascular, open, or percutaneous revascularization of each additional unilateral tibial or peroneal artery using transluminal angioplasty.It is used in conjunction with codes 37228-37231 (initial vessel revascularization) and should only be reported when performed on additional vessels after an initial procedure on a tibial or peroneal artery has already been performed and coded.The procedure involves restoring blood flow through the artery using a balloon catheter to widen a narrowed or blocked area.An open or percutaneous approach may be used.

Example 1: A patient presents with critical limb ischemia in the left leg due to significant blockages in the tibial and peroneal arteries. The physician performs a revascularization of the initial tibial artery (37228) and then performs additional revascularizations of 2 more peroneal arteries (2 x 37232)., A patient with peripheral artery disease (PAD) affecting multiple arteries in the right leg undergoes revascularization of the initial peroneal artery (37230) followed by revascularization of two additional tibial arteries (2 x 37232)., A patient with diabetes and severe lower extremity ischemia requiring revascularization of the initial tibial artery (37229) and a subsequent procedure on three additional peroneal arteries (3 x 37232).

Pre-operative assessment including imaging studies (angiography) demonstrating the need for revascularization. Intra-operative documentation detailing the approach (open, percutaneous, endovascular), location of the lesions, balloon inflation pressures, and post-angioplasty imaging to confirm successful revascularization.Post-operative notes, including the patient’s response to the procedure and any complications.

** This is an add-on code and requires a primary procedure code (37228-37231) to be reported.Appropriate documentation is crucial for reimbursement.Always refer to the most current CPT codebook and payer guidelines.

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