CPT® Code 37183

Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)

The CPT® Code 37183 refers to the procedure known as the revision of transvenous intrahepatic portosystemic shunt(s) (TIPS). This complex interventional radiology procedure is performed to address issues with existing TIPS, which are used to manage portal hypertension by creating a pathway between the portal and hepatic veins. The procedure involves several critical steps, including venous access, catheterization of the hepatic and portal veins, and the use of imaging techniques to guide the intervention. The physician typically gains access through the right internal jugular vein, utilizing fluoroscopic guidance to ensure precision during the catheter placement. Once access is established, contrast material is injected to visualize the portal system, allowing for the evaluation of the shunt's function and the identification of any complications. The procedure may involve recanalization or dilation of the intrahepatic tract, revision of the stent, or even replacement of a malfunctioning stent. Throughout the process, hemodynamic evaluations are conducted to assess the effectiveness of the shunt, and post-procedure venography may be performed to confirm the success of the intervention. This comprehensive approach ensures that the TIPS is functioning optimally, thereby improving patient outcomes in the management of portal hypertension.