CPT® Code 37237

Add-On Code

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; each additional artery (List separately in addition to code for primary procedure)

The CPT® Code 37237 refers to the transcatheter placement of an intravascular stent in any artery except for those located in the lower extremities, cervical carotid, extracranial vertebral, intrathoracic carotid, intracranial, or coronary 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 a small incision in the skin to expose the artery, allowing for the introducer sheath to be placed directly into the vessel. 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 the 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, and a long guiding sheath is placed over the catheter and stiff wire, which are subsequently removed, leaving the guiding sheath in place. Angioplasty may be conducted prior to stent placement, where a balloon catheter is inflated at the lesion site to dilate the narrowed area. After the balloon is deflated and removed, the stent delivery catheter is advanced to the lesion, where the stent is positioned and deployed. Following deployment, a balloon catheter may be used again to ensure the stent is properly seated. Additional angiograms are obtained to assess the placement and patency of the artery. Finally, all catheters are removed, and pressure is applied to the vascular access site to prevent bleeding. This code also encompasses all necessary radiological supervision and interpretation associated with the procedure.