2025 CPT code 37243
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vascular Embolization and Occlusion Procedures Surgery Feed
Vascular embolization or occlusion for tumors, organ ischemia, or infarction, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance.
Modifiers 59 (distinct procedural service) and others may apply depending on circumstances.Consult the AMA CPT manual and payer guidelines for modifier usage.
Medical necessity for this procedure is established when embolization is required to treat a tumor, control hemorrhage, or manage organ ischemia or infarction, consistent with accepted medical practice. The procedure must be deemed medically appropriate by the treating physician and supported by appropriate documentation.
The interventional radiologist or vascular surgeon is responsible for the procedure. This includes patient preparation, access to the target vessel, catheter placement, embolic agent delivery, and post-procedure care.Anesthesiologist may be involved.
In simple words: This medical procedure partially or completely blocks blood flow to a specific area in an organ.This is done to treat tumors, reduce blood flow to a damaged area, or stop bleeding. The doctor uses imaging and special tools to carefully block the blood vessels.
This CPT code encompasses vascular embolization or occlusion procedures performed to treat tumors, organ ischemia, or infarction.The procedure includes all necessary radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance to complete the intervention.It is inclusive of services such asradiological supervision, interpretation, intraprocedural guidance and road-mapping, and imaging to document procedure completion.Diagnostic angiography and catheter placement are not included and should be billed separately if performed.Examples include embolization for tissue ablation and organ infarction or ischemia, such as embolization of benign or malignant tumors in the liver, kidney, uterus, or other organs; uterine fibroid embolization; and selective internal radiation therapy (SIRT).
Example 1: Embolization of a hepatic tumor in a patient with hepatocellular carcinoma.The procedure involves selective catheterization of the hepatic artery followed by the delivery of embolic agents to occlude the tumor's blood supply., Embolization of uterine fibroids in a patient with heavy menstrual bleeding.The procedure involves selective catheterization of the uterine arteries, followed by the delivery of embolic agents to reduce blood flow to the fibroids., Embolization of a renal tumor in a patient with renal cell carcinoma. The procedure involves selective catheterization of the renal artery followed by the delivery of embolic agents to occlude the tumor's blood supply.Pre-procedural and post-procedural imaging is performed.
Detailed history and physical examination, including the indication for embolization;Pre-procedure imaging studies (e.g., CT, MRI, angiography) to locate the target vessel and assess tumor location and size;Consent form;Procedure report detailing the approach, catheterization technique, embolic agent used, and volume injected;Post-procedure imaging studies to confirm successful embolization; andFollow-up notes.
** This code should not be used for injection of macroaggregated albumin (MAA) in treatment planning.Always refer to the most current CPT guidelines and payer-specific policies for accurate coding and reimbursement.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: This information varies by location and payer. Consult the appropriate fee schedule for current RVU values.
- Global Days: The global period is not explicitly defined for this code.Refer to payer-specific guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier does not apply to this code.
- Fee Schedule: Historical fee schedule information is not provided in the source documents and is subject to change based on payer and geographic location.
- Specialties:Interventional Radiology, Vascular Surgery, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center