Summary & Overview
CPT 37195: Cerebral Thrombolytic Infusion for Clot Dissolution
CPT code 37195 denotes an interventional endovascular procedure in which a thrombolytic medication is infused via an intravenous catheter into a cerebral blood vessel to dissolve a clot and address acute cerebral ischemia. This intervention is clinically important because timely thrombolysis can reduce infarct size, improve neurological outcomes, and influence acute stroke care pathways nationwide. Payers commonly relevant to coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical context and procedural intent for CPT code 37195, along with what to expect in benchmarks and policy review sections. The publication covers national-level reimbursement benchmarks where available, common billing and documentation considerations tied to endovascular thrombolytic infusion, and recent payer policy trends affecting coverage determinations. When source data elements are not present in the input, the report notes "Data not available in the input." The content is intended for billing managers, hospital administrators, and clinicians involved in acute stroke services who need a clear reference to the code's purpose, expected settings of care, and payer landscape.
Billing Code Overview
CPT code 37195 describes the infusion of a thrombolytic agent through an intravenous catheter targeted at a cerebral (brain) blood vessel to dissolve an intravascular clot. The procedure is performed to resolve an occlusion in the brain vasculature and reduce the risk of ischemic stroke or limit its severity.
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Service type: Interventional endovascular thrombolytic infusion for cerebral vessel occlusion
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Typical site of service: Inpatient hospital or hospital-based interventional radiology/endovascular suite where acute neurovascular interventions are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to the emergency department with sudden-onset right-sided weakness, facial droop, and expressive aphasia that began 90 minutes earlier. Neurologic exam and an NIH Stroke Scale score suggest an acute ischemic stroke. Non-contrast head CT excludes hemorrhage. CT angiography demonstrates an occlusion of a major cerebral artery. The interventional team is consulted and prepares for intra-arterial thrombolytic infusion. The patient is transported to the angiography suite. Under conscious sedation or general anesthesia depending on airway and agitation, vascular access is obtained (commonly via common femoral arterial access) and a microcatheter is navigated to the site of occlusion. A thrombolytic agent is infused through the catheter into the cerebral vessel to dissolve the clot. The team monitors neurologic status, hemodynamics, and post-procedure neuroimaging is performed to assess reperfusion and rule out hemorrhagic conversion. The procedure is billed using 37195 for intra-arterial thrombolytic infusion to a cerebral vessel. Typical workflow involves ED stroke activation, rapid imaging, interventional radiology or neurointerventionalist consultation, angiographic procedure with intra-arterial drug delivery, and post-procedure ICU or stroke unit monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician's professional interpretation/service portion is reported separate from technical components (if applicable). |