Summary & Overview
CPT 37213: Catheter-Directed Thrombolytic Infusion
CPT code 37213 denotes a catheter-directed thrombolytic infusion procedure with radiological supervision and interpretation performed on a subsequent treatment day for non-coronary vessels. This code captures the targeted delivery of thrombolytic medication via arterial or venous catheter, including necessary catheter contrast injections and repositioning. Nationally, catheter-directed thrombolysis is a critical intervention for selected acute and subacute thrombotic conditions where systemic therapy is inadequate or carries higher risk.
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 service utilization, common billing considerations, and typical sites of service. The publication provides benchmarks for use frequency, payer coverage patterns, and recent policy updates affecting interventional radiology billing practices. It also outlines clinical scenarios in which CPT code 37213 is applied and highlights coding boundaries—specifically that this code represents a subsequent-day thrombolytic infusion for vessels other than coronary arteries.
This summary is intended for billing managers, interventional radiologists, and policy analysts seeking a practical, national-level reference on the clinical and coding scope of CPT code 37213.
Billing Code Overview
CPT code 37213 describes a radiologically guided procedure in which a catheter is inserted into an artery or vein to deliver a thrombolytic agent directly to a vascular thrombus. The service includes the radiological supervision and interpretation required to perform the infusion and covers catheter contrast injection, catheter position change, or catheter replacement when performed. This code is used for a subsequent day of thrombolytic therapy when the target vessel is other than a coronary artery.
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Service type: Catheter-directed thrombolytic infusion with radiological supervision and interpretation
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Typical site of service: Hospital inpatient or hospital outpatient interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old individual presenting with acute limb ischemia due to an arterial thrombus of a lower extremity. After vascular surgery and interventional radiology evaluation, the care team initiates catheter-directed thrombolysis to restore distal perfusion. The procedure is performed in an interventional radiology or endovascular suite under conscious sedation or monitored anesthesia care. The interventionalist obtains arterial access (commonly common femoral artery), advances a multi-sidehole infusion catheter into the thrombosed segment under fluoroscopic guidance, and begins continuous infusion of a thrombolytic agent (for example, alteplase) with serial angiographic assessments. The documented service for a subsequent treatment day of an ongoing thrombolytic infusion (when clot lysis requires repeated catheter-directed infusion but is not a coronary vessel) is billed with 37213. Clinical workflow elements include pre-procedure consent and coagulation assessment, vascular access and catheter placement, radiological supervision and interpretation during infusion and possible catheter repositioning or contrast injection, monitoring in the recovery area or ICU during therapy, and documentation of daily procedural notes that justify subsequent-day catheter-directed infusion therapy using 37213.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 |