2025 CPT code 37246
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Cardiovascular System - Endovascular Revascularization Surgery Feed
Transluminal balloon angioplasty of the initial artery (excluding lower extremity arteries for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuits), using an open or percutaneous approach, inclusive of all necessary imaging and radiological supervision.
Modifiers may be necessary based on the circumstances of the procedure, including but not limited to: modifier -59 (distinct procedural service) if the angioplasty is performed as a distinct procedure from another service during the same session, or modifier -22 (increased procedural service) if the angioplasty was significantly more complex than usual.
Medical necessity is established by clinical symptoms indicative of arterial stenosis or occlusion (e.g., claudication, ischemia), confirmed by diagnostic imaging. The procedure is medically necessary to restore blood flow, alleviate symptoms, and prevent complications such as limb loss or organ damage. Documentation should clearly demonstrate the relationship between the symptoms, imaging findings, and the need for the angioplasty.Specific payer requirements should also be met.
A physician specializing in interventional cardiology or vascular surgery performs this procedure. Responsibilities include patient assessment, selecting the appropriate approach (open or percutaneous), inserting catheters and guidewires, inflating the balloon to clear blockages, monitoring blood flow using angiography, and ensuring proper wound closure.Post-procedure care and follow up are also within the clinical responsibility.
In simple words: This code describes a procedure to open up a blocked artery using a tiny balloon on a thin tube. The doctor inserts the tube into the artery and inflates the balloon to push aside the blockage, improving blood flow.This includes all the imaging tests needed during the procedure. It does not include procedures on the arteries in your legs, brain, heart, or lungs, or the tubes used for dialysis.
This CPT code, 37246, encompasses transluminal balloon angioplasty performed on the initial artery.The procedure can be done via an open incision or percutaneously. It includes all imaging guidance and diagnostic imaging required to perform the angioplasty, along with the necessary radiological supervision and interpretation (RSI).This code excludes angioplasty on lower extremity arteries with occlusive disease, intracranial, coronary, pulmonary arteries, or dialysis circuits.The code describes the angioplasty itself, not the catheterization procedures leading up to it which are billed separately. Multiple angioplasties within the same artery are coded only once. Additional angioplasties in separate arteries are billed using additional codes.
Example 1: A patient presents with symptoms of peripheral artery disease in the arm.Angiography reveals a significant blockage in the brachial artery.The physician performs a transluminal balloon angioplasty using a percutaneous approach, successfully restoring blood flow. Code 37246 is reported for this initial artery., A patient with renal artery stenosis undergoes a percutaneous transluminal angioplasty of the right renal artery. The procedure successfully opens the artery. Code 37246 is used to report this initial renal artery angioplasty., A patient experiences symptoms consistent with mesenteric ischemia.Angiography reveals a stenosis in the superior mesenteric artery.The physician performs a transluminal angioplasty via a percutaneous approach, resolving the stenosis. The initial angioplasty is coded with 37246.
Complete medical history and physical examination,angiography images before and after the procedure clearly showing the location and extent of the stenosis and the result of the angioplasty, operative report detailing the approach (open or percutaneous), catheterization details, balloon inflation parameters, and the assessment of post-procedural blood flow.Imaging reports should also be included.
** This code should only be used for initial artery angioplasty.Additional angioplasties within the same artery are not separately reported.Always verify the appropriateness of the code based on the specific clinical circumstances and payer requirements.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is generally not applicable to this code since it inherently includes the technical aspects of the procedure.
- Specialties:Interventional Cardiology, Vascular Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center