CPT® Code 37236

Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery

The CPT® Code 37236 refers to the transcatheter placement of an intravascular stent in any artery except for those located in the coronary, cervical carotid, intrathoracic carotid, extracranial vertebral, intracranial, or lower extremity regions. This procedure can be performed using either an open or percutaneous approach. In the percutaneous method, access is typically gained through the femoral artery or another suitable access artery, where a puncture is made, and an introducer sheath is inserted to facilitate the procedure. Conversely, the open approach involves surgically exposing the artery through a small incision, allowing for the direct insertion of the introducer sheath. This method is particularly advantageous in cases of severe arteriosclerotic disease affecting the femoral or iliac arteries, where access may be more challenging. During the procedure, a guide wire is introduced and navigated to the site of stenosis, followed by the advancement of a catheter over the guide wire. Roadmapping angiograms are performed to visualize the anatomy and the stenotic area. A stiff wire is then advanced to the stenosis site, and a long guiding sheath is placed over the catheter and stiff wire. After removing the catheter and stiff wire, the guiding sheath remains in position. Angioplasty may be conducted prior to stent placement, where a balloon catheter is inflated at the lesion site to dilate the narrowed area. Following this, the stent delivery catheter is advanced to the lesion, and the stent is deployed and positioned accurately. A subsequent inflation of a balloon catheter may be performed to ensure proper seating of the stent. Finally, additional angiograms are obtained to assess the stent placement and the patency of the artery, after which all catheters are removed, and pressure is applied to the vascular access site. This code encompasses all necessary radiological supervision and interpretation associated with the procedure.