CPT® Code 37249

Add-On Code

Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure)

Transluminal balloon angioplasty is a specialized endovascular procedure designed to treat narrowing or obstruction in veins. This technique employs fluoroscopy, a type of medical imaging that allows real-time visualization of the veins during the procedure. The process begins with accessing the vein, which can be achieved either percutaneously or through an open surgical approach. In the percutaneous method, a needle is inserted through the skin into a blood vessel located in the groin, arm, or neck. A guidewire is then threaded through this needle, and the needle is subsequently replaced with a vascular sheath to facilitate the introduction of other instruments. In contrast, the open access method involves making an incision directly over the targeted vessel, allowing for direct access to the vein. Once access is established, a vascular catheter is inserted over the guidewire, and contrast dye is injected to enhance the visibility of the vein and to identify any areas of narrowing or disease. Following this, the vascular catheter is replaced with a balloon catheter, which is carefully advanced to the site of the obstruction. The balloon is then inflated with a dilute contrast dye, which serves to expand the vessel and alleviate the blockage. After a predetermined duration, the balloon is deflated and removed. To ensure the effectiveness of the procedure, a vascular catheter is reinserted, and angiography is performed again to assess whether the vein has been successfully opened or if there remains any residual stenosis that may require further intervention. The CPT® Code 37248 is used to report the balloon angioplasty performed on the initial vein, while CPT® Code 37249 is designated for each additional vein treated during the same session.