2025 CPT code 37500
Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS).
Yes, applicable modifiers are 22, 47, 50, 51, 52, 53, 54, 55, 56, 58, 59, 62, 73, 74, 76, 77, 78, 79, 99, and others as applicable.
Medical necessity for SEPS must be established by documenting the presence of venous insufficiency, perforator vein incompetence, and the failure of conservative treatments.The clinical findings supporting the diagnosis and the rationale for SEPS should be clearly documented.
The surgeon performs the procedure, including prepping and anesthetizing the patient, making incisions, inserting the endoscope and catheter, identifying and ligating the perforator veins, suturing the incisions, and providing post-operative care such as elastic stockings.
In simple words: A minimally invasive procedure using a small camera (endoscope) to close off faulty veins beneath the surface of the skin, typically in the leg. This helps improve blood flow and heal venous ulcers.
This procedure involves the surgical placement of an endoscope to ligate perforator veins subfascially.The surgeon makes a small incision, typically in the calf, inserts a balloon catheter for access, and creates additional small incisions for port entry. Using the endoscope, the surgeon identifies and detaches perforated veins below the fascia, then ties them off or transects them. The incisions are then sutured.This procedure is often used to treat venous ulcers by improving circulation.
Example 1: A patient presents with a non-healing venous ulcer on the lower leg. Subfascial endoscopic perforator surgery (SEPS) is performed to improve blood flow and promote healing., A patient with chronic venous insufficiency and persistent leg swelling undergoes SEPS to address incompetent perforator veins., A patient with recurrent venous thrombosis and perforator vein incompetence undergoes SEPS as part of a comprehensive treatment plan.
Documentation should include the patient's medical history, the presence and severity of venous disease, the location and size of the ulcer (if present), the procedure details (incisions, veins ligated), and any complications.
- Revenue Code: P8I - ENDOSCOPY - OTHER
- Specialties:Vascular Surgery, Interventional Radiology, General Surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient