CPT® Code 37238

Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein

The CPT® Code 37238 refers to the transcatheter placement of an intravascular stent in a vein, which can be performed either through an open or percutaneous approach. This procedure includes the necessary radiological supervision and interpretation, as well as angioplasty within the same vessel if it is performed. The term "initial vein" indicates that this code is used for the first vein treated during the procedure. In practice, venous stents are typically placed in various veins, with the iliac vein being the most common site. The procedure begins with the puncture of the femoral vein, through which an introducer sheath is inserted to facilitate access. A guidewire is then navigated to the area of stenosis, followed by the advancement of a catheter over the guidewire. Roadmapping venograms are obtained to visualize the anatomy and the lesion. Subsequently, a balloon catheter is used to dilate the lesion, and after its removal, the stent delivery catheter is positioned and the stent is deployed. The procedure may involve additional steps, such as inflating a balloon catheter to ensure proper seating of the stent and obtaining further venograms to assess the stent placement and the patency of the vein. It is important to note that this code is specifically designated for the initial vein treated, while additional veins treated during the same session would be coded using CPT® Code 37239. This comprehensive description encapsulates the essential elements of the procedure, ensuring clarity for medical coders and healthcare professionals involved in the billing and documentation process.