Summary & Overview
CPT 37193: Percutaneous Removal of Inferior Vena Cava Filter
CPT code 37193 represents percutaneous endovascular removal of an inferior vena cava (IVC) filter using catheter-directed techniques and imaging guidance. This procedure is clinically important because retrieval of temporary or retrievable IVC filters reduces long-term complications associated with indwelling filters, such as migration, fracture, and thrombosis. Nationally, appropriate coding and coverage policies for filter retrieval influence utilization, access to interventional radiology services, and post-thromboembolic care pathways.
Key payers commonly considered in analyses of this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Payer policies vary on medical necessity criteria, documentation requirements, and site-of-service preferences, which affect authorization and reimbursement practices.
Readers will find an overview of the clinical procedure and typical sites of service, a summary of how major payers approach coverage, and contextual information on coding, common modifiers, and related billing considerations. The publication also highlights benchmarks and policy updates affecting utilization and payer authorization, and offers clinical context to clarify when removal procedures are typically indicated. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 37193 describes a procedure in which the provider inserts a catheter through a vein in the groin or neck, advances the catheter to the inferior vena cava (IVC), and removes a previously placed IVC filter under imaging guidance. This procedure is performed when the filter is no longer required to prevent embolization of thrombi from the lower extremities to the heart and lungs.
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Service type: Percutaneous endovascular removal of inferior vena cava filter (catheter-directed retrieval)
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Typical site of service: Hospital-based interventional radiology suite or endovascular operating room; may also be performed in an outpatient ambulatory surgery center with appropriate imaging capability.
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient with a history of deep venous thrombosis (DVT) after a traumatic lower-extremity fracture had an infrarenal inferior vena cava (IVC) filter placed emergently 6 months earlier because of contraindication to anticoagulation. The patient has now completed definitive treatment, is ambulatory, anticoagulation is therapeutic, and imaging (venous duplex/CT venography) demonstrates the filter is no longer indicated and is retrievable. The interventional radiology team schedules an outpatient endovascular retrieval. The patient arrives to the vascular/interventional suite, obtains informed consent, and undergoes moderate sedation per institutional protocol. Using ultrasound guidance, the operator obtains venous access in the right common femoral vein, advances a sheath and catheter under fluoroscopic guidance to the filter in the infrarenal IVC, engages the filter with a snare or retrieval device, and removes the filter intact. Post‑retrieval venography confirms patency of the IVC and absence of residual thrombus or injury. The patient is monitored in recovery and discharged the same day with instructions for access site care and follow-up imaging as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normally expected performance modifier | When the procedure is the primary and performed as planned without unusual circumstances. |