CPT® Code 37620

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Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular (umbrella device)

The procedure described by CPT® Code 37620 involves the interruption of blood flow in the inferior vena cava (IVC), which is a major vein that carries deoxygenated blood from the lower body to the heart. This interruption can be either partial or complete and is performed to prevent the occurrence of pulmonary embolism, a serious condition that arises when blood clots, known as deep vein thromboses, migrate from the pelvis or lower extremities to the lungs. The physician may utilize different techniques to achieve this interruption. An extravascular approach includes methods such as suture, ligation, plication, or the application of a clip to the IVC. Alternatively, an intravascular approach may involve the placement of a filter within the IVC, which is designed to capture blood clots and prevent them from traveling to the lungs. These filters are often umbrella-shaped devices that expand within the vein to trap clots. Prior to performing the interruption, a cavogram is conducted to assess the vascular anatomy and to ensure that there are no existing thrombi within the IVC. If the extravascular technique is chosen, the procedure necessitates an abdominal incision to expose the IVC, allowing the surgeon to manipulate the vessel directly. Conversely, if the intravascular technique is selected, access is gained through either the femoral or jugular vein, and a series of steps involving guidewires and catheters are followed to position the filter accurately within the IVC. This comprehensive approach ensures that the procedure is tailored to the patient's specific anatomical and clinical needs while effectively mitigating the risk of pulmonary embolism.