CPT 37192 IVC Filter Repositioning Reimbursement | OpenPayer

Summary & Overview

CPT 37192: Image-Guided Repositioning of IVC Filter

CPT code 37192 represents an image-guided, percutaneous endovascular procedure to reposition an already placed inferior vena cava (IVC) filter via catheter access through the groin or neck. This procedure matters nationally because IVC filters play a key role in preventing pulmonary embolism when anticoagulation is contraindicated or ineffective, and safe repositioning can reduce complications and preserve filter function without complete device removal.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical context and appropriate sites of service, plus benchmarking and policy-focused content where available. The publication outlines common billing considerations, typical payer coverage patterns, and areas where prior authorization or documentation can affect claim outcomes. It also summarizes coding nuances and related service lines to help clinical and revenue teams align clinical documentation with billing requirements.

This resource is intended for national audiences including clinicians, coding professionals, and healthcare administrators seeking a clear summary of the clinical purpose and billing implications of CPT code 37192. Data not available in the input are noted where necessary elsewhere in the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37192CPTIVC filterinterventional radiologyendovascular procedureimage-guidedprocedure codingvascular surgerypulmonary embolism prevention

Billing Code Overview

CPT code 37192 describes a percutaneous, image-guided procedure in which a provider inserts a catheter through a vein at the groin or neck and maneuvers it to reposition an existing inferior vena cava (IVC) filter. The procedure uses real-time imaging to visualize the venous anatomy and ensure accurate repositioning of the filter to a more appropriate location within the IVC so the device can prevent thromboemboli from the lower extremities reaching the heart and lungs.

Service type: Image-guided endovascular repositioning of an implanted IVC filter
Typical site of service: Hospital-based interventional radiology suite or operating room; may also occur in specialized outpatient vascular/interventional centers when appropriate

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a previously implanted inferior vena cava (IVC) filter presents for outpatient endovascular repositioning after imaging demonstrates migration of the filter away from the intended infrarenal IVC location. The patient has a history of deep vein thrombosis (DVT) of the lower extremity and an IVC filter was placed prophylactically to prevent pulmonary embolism. The interventional radiology team evaluates preprocedure cross-sectional imaging (CT venography or abdominal ultrasound) and reviews anticoagulation status and renal function. On the day of service, the patient receives sterile prep and local anesthesia with conscious sedation; vascular access is obtained via the common femoral vein (or internal jugular vein) using ultrasound guidance. Under fluoroscopic and digital subtraction angiographic guidance, the provider advances a catheter to the filter, manipulates and repositions the device to the predetermined appropriate level in the IVC, verifies satisfactory placement with contrast venography, and obtains hemostasis at the access site. Postprocedure monitoring includes observation for access complications, vital signs, and instructions regarding resumption of anticoagulation. Typical sites of service are the hospital catheterization laboratory, interventional radiology suite, or ambulatory surgical center. Service type: image-guided endovascular filter repositioning.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (basic reporting)	Use when no additional coding modifier applies; standard reporting of the service.

CPT 37191: Inferior Vena Cava Filter Placement

CPT-37214-CATHETER-DIRECTED-THROMBOLYTIC-INFUSION

CPT 37214: Catheter-Directed Thrombolytic Infusion

CPT-37213-CATHETER-DIRECTED-THROMBOLYTIC-INFUSION

CPT 37213: Catheter-Directed Thrombolytic Infusion

CPT-37200-TRANSCATHETER-VASCULAR-BIOPSY

CPT 37200: Transcatheter Vascular Biopsy, Intravascular Tissue Sampling

CPT-37216-CAROTID-ARTERY-STENT-PLACEMENT-ANGIOPLASTY

CPT 37216: Carotid Artery Stent Placement with Angioplasty

CPT-37218-INTRATHORACIC-CAROTID-INNOMINATE-ARTERY-STENT-PLACEMENT

CPT 37218: Intrathoracic Common Carotid or Innominate Artery Stent Placement

CPT-37215-CAROTID-ARTERY-STENT-PLACEMENT-EMBOLIC-PROTECTION

CPT 37215: Carotid Artery Stent Placement with Embolic Protection

CPT-37211-CATHETER-DIRECTED-THROMBOLYSIS-ARTERIAL

CPT 37211: Catheter-Directed Arterial Thrombolytic Infusion

CPT-37195-CEREBRAL-THROMBOLYTIC-INFUSION

CPT 37195: Cerebral Thrombolytic Infusion for Clot Dissolution

CPT-37193-IVC-FILTER-REMOVAL-PERCUTANEOUS

CPT 37193: Percutaneous Removal of Inferior Vena Cava Filter

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Taxonomy Code	Specialty	Notes
2088P0800X	Interventional Radiology	Most common specialty performing image-guided IVC filter repositioning.
207K00000X	Vascular Surgery	Vascular surgeons perform endovascular filter management and repositioning.
207P00000X	Cardiothoracic / Peripheral Vascular Surgery	Peripheral vascular interventionalists may perform this procedure in hybrid OR settings.
163WP0800X	Diagnostic Radiology	Diagnostic radiologists with interventional privileges perform image-guided vascular procedures.
363LF0000X	Interventional Cardiologist	In some centers, interventional cardiologists with endovascular experience perform venous interventions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	DVT is a primary indication for IVC filter placement and may be present in patients requiring filter repositioning.
`I82.402`	Acute embolism and thrombosis of unspecified deep veins of left lower extremity	Same clinical relevance for left-sided DVT prompting IVC filter management.
`I82.403`	Acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities	Bilateral DVT increases embolic risk and relevance for filter positioning.
`Z79.01`	Long term (current) use of anticoagulants	Anticoagulation status influences decision-making for filter management and repositioning.
`T82.89XA`	Other complications of other cardiac and vascular devices and implants, initial encounter	Captures device migration, malposition, or other complications of IVC filters prompting repositioning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36200`	Introduction of catheter, arterial system; not otherwise specified	May be used when arterial catheterization is required for access or imaging in a combined arterial/venous procedure.
`36465`	Placement of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older	Often performed in the same patient population for venous access needs but not directly related; included when additional venous access procedures are performed.
`37220`	Revascularization, endovascular, open or percutaneous, femoral-popliteal artery; initial artery treated	Represents endovascular skill set; may be performed in the same interventional session when concomitant arterial interventions are required.
`76937`	Ultrasound guidance for vascular access requiring an additional physician or qualified health care professional	Used when ultrasound-guided vascular access is separately reportable and meets payer criteria.
`Radiology only: 77012`	Fluoroscopic guidance for vascular procedures (non-specific)	Fluoroscopic imaging guidance is integral to `37192`; some payers require separate reporting of advanced imaging guidance depending on local policy.

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