CPT 37211 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 37211: Catheter-Directed Arterial Thrombolytic Infusion

CPT code 37211 represents catheter-directed thrombolytic infusion into an arterial thrombus (excluding coronary and intracranial arteries) with the reporting physician providing the radiological supervision and interpretation for vascular access on the initial treatment day. This code describes a time-sensitive, image-guided endovascular intervention frequently used to restore arterial patency in limb- or organ-threatening ischemia. Nationally, proper coding for this service affects claims accuracy, facility and professional payment alignment, and quality measurement for acute vascular care.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, allowed payment benchmarks, and common billing modifiers used with this service. The publication also summarizes clinical context — when catheter-directed arterial thrombolysis is typically used and the usual sites of service — and highlights documentation elements that influence correct code selection and claim adjudication. Where payer-specific policy language or reimbursement trends are not provided in the input, the report will note "Data not available in the input."

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37211CPTcatheter-directed thrombolysisinterventional radiologyendovasculararterial thrombosisvascular surgeryhospital outpatientinpatient

Billing Code Overview

CPT code 37211 describes catheter-directed infusion of a thrombolytic agent into an artery at the site of an arterial thrombus, performed for an artery other than a coronary or non–intracranial artery. The procedure includes the physician's radiological supervision and interpretation used to access the target vessel and is reported for the initial day of treatment.

Service type: Catheter-directed thrombolytic therapy (endovascular interventional radiology procedure)
Typical site of service: Hospital inpatient or hospital outpatient interventional radiology suite, or specialized vascular surgery/endovascular centers

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with acute limb ischemia presents to the hospital with sudden onset severe pain, pallor, and pulselessness of the right lower extremity. Vascular surgery and interventional radiology evaluate the patient and determine catheter-directed thrombolysis is indicated to dissolve an arterial thrombus in the popliteal artery to restore perfusion. On the initial treatment day the interventionalist obtains arterial access (commonly common femoral artery), navigates a catheter into the occluded arterial segment under fluoroscopic guidance, administers a thrombolytic infusion (e.g., tissue plasminogen activator) into the clot, and performs radiological supervision and interpretation during catheter placement and infusion initiation. The procedure is typically performed in an interventional radiology suite or hybrid operating room with continuous monitoring and potential vascular surgery backup. Post-procedure, the patient is observed in a monitored bed for neurovascular checks, laboratory monitoring (including coagulation parameters), and assessment for bleeding complications; subsequent infusion days use follow-on codes for continuation of therapy if required.

Coding Specifications

Modifier	Description	When to Use
`00`	Not a valid modifier for Medicare billing	Data not available in the input.
`11`

CPT 37218: Intrathoracic Common Carotid or Innominate Artery Stent Placement

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

CPT-37213-CATHETER-DIRECTED-THROMBOLYTIC-INFUSION

CPT 37213: Catheter-Directed Thrombolytic Infusion

CPT-37192-IVC-FILTER-REPOSITIONING-IMAGE-GUIDED

CPT 37192: Image-Guided Repositioning of IVC Filter

CPT-37191-INFERIOR-VENA-CAVA-FILTER-PLACEMENT

CPT 37191: Inferior Vena Cava Filter Placement

CPT-37214-CATHETER-DIRECTED-THROMBOLYTIC-INFUSION

CPT 37214: Catheter-Directed Thrombolytic Infusion

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

CPT 37215: Carotid Artery Stent Placement with Embolic Protection

CPT-37200-TRANSCATHETER-VASCULAR-BIOPSY

CPT 37200: Transcatheter Vascular Biopsy, Intravascular Tissue Sampling

CPT-37197-PERCUTANEOUS-ENDOVASCULAR-FOREIGN-BODY-REMOVAL

CPT 37197: Percutaneous Endovascular Foreign Body Removal

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Taxonomy Code	Specialty	Notes
207P00000X	Interventional Cardiology / Vascular Interventionalist	Providers trained in endovascular interventions who perform catheter-directed arterial therapies.
208100000X	Diagnostic Radiology / Interventional Radiology	Interventional radiologists commonly perform catheter-directed thrombolysis and radiologic supervision/interpretation.
208000000X	Vascular Surgery	Vascular surgeons perform endovascular thrombolysis and manage surgical backup and complications.
207RG0400X	Interventional Cardiology	Applicable when interventional cardiologists perform peripheral arterial interventions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Common indication for catheter-directed arterial thrombolysis to restore limb perfusion.
`I74.5`	Embolism and thrombosis of iliac artery	Thrombus in iliac artery amenable to catheter-directed lysis.
`I74.9`	Arterial embolism and thrombosis, unspecified	Used when a specific arterial site is not otherwise specified but thrombolysis is clinically indicated.
`I65.29`	Occlusion and stenosis of unspecified carotid artery (not intracranial when applicable)	When peripheral arterial thrombus involves extracranial carotid segments — procedural applicability depends on anatomy and stroke protocols.
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	Included when differential diagnosis requires addressing arterial and venous thrombotic disease; primarily venous codes are not direct indications but may coexist.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37211`	Catheter-directed thrombolysis, arterial, not coronary or intracranial, initial treatment day — including radiological supervision and interpretation	Primary code for the initial day of catheter-directed arterial thrombolytic infusion for a non-coronary, non-intracranial arterial occlusion.
`37212`	Catheter-directed thrombolysis, arterial, not coronary or intracranial, subsequent infusion(s) by same physician (per day)	Billed for each additional treatment day of catheter-directed arterial thrombolysis after the initial day when continued infusion is required.
`36215`	Selective catheter placement, arterial system; each first-order thoracic, abdominal, or pelvic branch, inclusive	Used for selective catheter placement into the vessel supplying the occluded segment prior to thrombolytic infusion when separate from thrombolysis work.
`36216`	Selective catheter placement, arterial system; each additional second-order or third-order branch, when performed	Used for additional selective catheter maneuvers in the arterial tree as needed to reach the thrombus.
`75898`	Radiological supervision and interpretation; intraprocedural radiological supervision and interpretation for vascular radiologic procedures	May be reported as applicable when additional radiologic supervision/interpretation time is significant and billable separate from the global service, per payer rules.
`37618`	Venous thrombectomy, mechanical, percutaneous; single or multiple venous segments (when venous adjunct procedures are required)	Used when concomitant percutaneous venous interventions are performed in the same setting for venous thrombotic disease; included here for completeness when differential vascular pathology is treated.

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