Summary & Overview
CPT 37214: Catheter-Directed Thrombolytic Infusion
CPT code 37214 represents catheter-directed thrombolytic infusion into an arterial or venous clot with radiological supervision and interpretation, including catheter contrast injection, position change or replacement, and procedural termination with catheter removal and vessel closure. This intervention is clinically important for treating acute thrombotic occlusions outside the coronary circulation and can span multiple treatment days, with this code used for subsequent-day therapy or for final cessation of therapy. Nationally, use of this code reflects access to advanced interventional radiology and vascular services for acute limb- and organ-sparing thrombolysis.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical and procedural scope of 37214, typical sites of service, and which payers commonly cover catheter-directed thrombolytic therapy. The publication also outlines billing context such as common modifiers and related service considerations. This resource is intended to support administrators, coding professionals, and clinical leaders seeking a clear, national-level summary of the code's clinical meaning, operational setting, and payer landscape.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 37214 describes catheter-directed infusion of a thrombolytic agent into an artery or vein at the site of a vascular clot, with radiological supervision and interpretation. The service includes catheter contrast injection, catheter position changes or replacement, and may be used for a subsequent treatment day during a course of thrombolytic therapy (other than for a coronary vessel). The code also encompasses cessation of thrombolytic therapy, removal of the catheter, and vessel closure by any method.
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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 suites and vascular procedure areas where catheter-based thrombolytic therapy is performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents with acute limb ischemia of the left lower extremity characterized by sudden onset pain, pallor, decreased pulses, and sensory deficit. Vascular imaging (CTA or duplex) identifies an occlusive thrombus within the popliteal and proximal tibial arteries. The interventional radiology or vascular surgery team admits the patient for catheter-directed thrombolytic therapy. On the initial day, an angiographic catheter is placed into the affected arterial segment and a bolus plus continuous infusion of a thrombolytic agent is started under continuous hemodynamic and laboratory monitoring. Radiological supervision and interpretation are provided during catheter placement and infusion adjustments. Over subsequent hospital days, the patient undergoes one or more subsequent infusion treatment days where the catheter is repositioned as needed, catheter contrast injections are performed to assess lysis progress, and the infusion is continued. On the final treatment day, the thrombolytic infusion is stopped, the catheter is removed, and the arterial access site is closed by percutaneous means.
Typical workflow elements include pre-procedure consent and coagulation assessment, image-guided catheter placement and diagnostic angiography, initiation of thrombolytic infusion, daily radiologic assessment with possible catheter repositioning or contrast injections, monitoring by the clinical team for bleeding or reperfusion, and final cessation of therapy with catheter removal and vessel closure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider is the usual or routine practitioner | When the furnishing physician is the primary reporting provider for the service |
22 | Increased procedural services | When work, time, or complexity substantially exceeds typical requirements for 37214 |
23 | Unusual anesthesia | When general anesthesia or deep sedation was required for the procedure |
50 | Bilateral procedure | If bilateral arterial catheter-directed thrombolysis is performed in the same session (use per payer guidance) |
51 | Multiple procedures | When 37214 is reported with other distinct procedures the same day (subject to payer bundling rules) |
52 | Reduced services | When the procedure was partially reduced or not completed as originally planned |
53 | Discontinued procedure | When the procedure was started but terminated for patient-related or intra-procedural reasons |
59 | Distinct procedural service | To indicate a distinct and separate service from other procedures performed the same day (use with caution and documentation) |
62 | Two surgeons | When two surgeons from different specialties are required and both are reporting portions of the service |
78 | Return to operating room for related procedure during global period | When a related reoperation is performed during the global period for the same site |
79 | Unrelated procedure during global period | Not listed in input modifiers; not applicable here |
LT | Left side | When the procedure is performed on the left sided vessel |
RT | Right side | When the procedure is performed on the right sided vessel |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RG0100X | Interventional Radiology | Primary specialty performing catheter-directed thrombolysis and image interpretation |
208600000X | Vascular Surgery | Commonly performs endovascular thrombolytic procedures and access management |
207P00000X | Diagnostic Radiology | Provides angiographic imaging and supervision/interpretation during infusion |
3336C0004X | Critical Care Medicine | Involved when patients require ICU-level monitoring during thrombolytic infusion |
207L00000X | Neuroradiology | Included when non-coronary thrombolysis involves cerebral vessels (note: 37214 excludes coronary vessels) |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I74.3 | Embolism and thrombosis of lower extremity arteries | Common indication for catheter-directed thrombolysis to restore limb perfusion |
I74.01 | Embolism and thrombosis of right femoral artery | Site-specific arterial occlusion treated with local thrombolysis |
I74.02 | Embolism and thrombosis of left femoral artery | Site-specific arterial occlusion treated with local thrombolysis |
I82.401 | Acute embolism and thrombosis of unspecified deep veins of right lower extremity | Deep venous thrombosis when treated with catheter-directed thrombolysis in some scenarios |
I82.402 | Acute embolism and thrombosis of unspecified deep veins of left lower extremity | As above for the left side |
G08 | Intracranial and intraspinal phlebitis and thrombophlebitis | Included when non-coronary thrombolysis involves neurovascular thrombus (selected scenarios) |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36200 | Introduction of catheter, arterial system; for diagnostic angiography, initial vessel catheterization | May be performed immediately prior to 37214 for diagnostic angiography and arterial access |
36245 | Selective catheterization, iliac, or lower extremity arteries | Used when selective catheter placement is needed to localize thrombolytic infusion site before or during 37214 |
37211 | Transcatheter therapy, percutaneous, infusion for thrombolysis; initial treatment day, non-coronary | Represents the initial-day catheter-directed thrombolysis; 37214 is used for subsequent treatment days or termination of therapy |
76000 | Fluoroscopy (separate procedure) | Fluoroscopic guidance and imaging are integral to catheter placement and monitoring during 37214; imaging components may be reported per payer rules |
93010 | Electrocardiogram interpretation and report | May be performed as part of monitoring during thrombolytic therapy when cardiac monitoring is clinically indicated |