Summary & Overview
CPT 3551F: Clinical Performance Measure
CPT code 3551F is recorded in the CPT code set as a performance or data-reporting measure; the source input provides no summary text. Such CPT performance codes are used in clinical documentation and reporting to indicate the presence, absence, or status of a defined clinical quality element. Nationally, these measures support quality reporting, care coordination, and can affect payer reporting workflows.
Key payers addressed in this profile include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s purpose, the likely service context where such a measure would be recorded, and which major payers typically incorporate CPT performance measures into coverage and reporting processes. Where specific information is missing from the input, the profile flags that data is not available in the input.
This publication is intended to orient billing staff, policy analysts, and clinical documentation specialists to the role of CPT performance codes like 3551F, and to summarize what to expect from payer engagement and reporting implications at a national level.
Billing Code Overview
CPT code 3551F has no detailed summary available in the source description. Based on the code label, this entry represents a discrete clinical or administrative performance measure as defined within the CPT coding framework. The service type is not specified in the input; Data not available in the input.
The typical site of service is not specified in the input; Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to interventional cardiology or vascular surgery for evaluation and management of peripheral arterial disease (PAD) with clinical symptoms such as claudication, rest pain, or nonhealing lower-extremity ulceration. The patient presents to an outpatient vascular lab or hospital catheterization suite after noninvasive testing (ABI, duplex ultrasound, or CTA) demonstrates significant arterial stenosis or occlusion. The clinical workflow includes pre-procedure evaluation (history, medication reconciliation including antiplatelet/anticoagulant management), informed consent, vascular access (commonly femoral), diagnostic angiography to localize lesion(s), and then endovascular intervention (angioplasty, stent placement, atherectomy) as indicated. Post-procedure includes hemostasis, monitoring for access-site complications, discharge instructions, and arrangement for follow-up imaging and medical therapy optimization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a documented E/M visit is provided on the same day as the procedure and is medically necessary and distinct |
59 |