Embolization Procedures

CPT Code Descriptions Non‐CNS and Non Head/Neck 37241 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles) 37242 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms) 37243 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction 37244 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation CNS & Head/ Neck RS&I Codes 61624 Transcatheter permanent occlusion or embolization (eg, for 75894 Transcatheter therapy, tumor destruction, to achieve hemostasis, to occlude a vascular embolization, any method, radiological malformation), percutaneous, any method; central nervous system supervision and interpretation (intracranial, spinal cord) 75898 Angiography through existing catheter for follow‐up study for transcatheter therapy, embolization or infusion, other than thrombolysis 61626 Transcatheter permanent occlusion or embolization (eg, for 75894 Transcatheter therapy, tumor destruction, to achieve hemostasis, to occlude a vascular embolization, any method, radiological malformation), percutaneous, any method; non‐central nervous supervision and interpretation system, head or neck (extracranial, brachiocephalic branch) 75898 Angiography through existing catheter for follow‐up study for transcatheter therapy, embolization or infusion, other than thrombolysis

Embolization Coding – Operative Fields All embolization codes 37241‐37244, 61624, 61624, 75894, & 75898 are assigned once per operative field. 1 Operative Field 2 Operative Fields Multiple vessels feeding a bladder tumor Bilateral organs – each organ separate field Multiple vessels in the same extremity Bilateral arteriovenous malformations Multiple hemodialysis side branches Bilateral testicular veins ‐ varicocele Multiple vessels for endoleak ‐ AAA Bilateral ovarian veins – pelvic congestion Multiple vessels feeding a liver tumor Intracranial aneurysms (2+) Bilateral uterine arteries Multiple bleeds (eg. pelvis, spleen)

Embolization Procedures

37241‐37244 Clinical Indication 37241 37242 37243 37244 Venous malformations X Hemodialysis side branches X Capillary hemangiomas X Varicoceles X Visceral varices (Gastric, Esophageal) X Pelvic congestion syndrome (Incompetent Ovarian Veins) X Lymphatic malformations (vascular malformations primarily lymphatic) X Arteriovenous malformations X Arteriovenous fistulas X Aneurysm X Pseudoaneurysm X Pre‐operative examination X Tissue ablation X Liver Tumor X Kidney Tumor X Uterine Fibroids X Vertebral Body Tumor X Organ Infarction X Organ Ischemia X GI bleed X Hemorrhage, traumatic, viscera or pelvis X Chylorus effusion – thoracic duct X Hemoptysis – bronchial artery X Hemorrhage – post partum X

If there is more than one clinical indication requiring embolization, the code for the immediate indication for the embolization is the one that will determine the correct code. For example, if bleeding in a patient with an aneurysm necessitates the embolization, code 37244 should be assigned.

CNS & Non CNS Vessel Treated 61624 61626 75898 75894 75894 Central Nervous System (arterial or venous) X Add when documented Brain – intracranial lesions, meningioma X Add when documented Spinal Cord – intraspinal lesions X Add when documented Non Central Nervous System X Add when documented Sphenopalatine or maxillary for nosebleed X Add when documented Thyroidal X Add when documented Face or Neck X Add when documented Note: Intracranially code 75898 may be used as often as medically necessary (ie, single aneurysm and followup angiography is performed after each coil placement).