CPT 37239 Venous Stent: Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 37239: Secondary Venous Stent Insertion, Endovascular

CPT code 37239 covers insertion of a stent in a vein via catheter access performed after stent insertion in a separate vein, with radiological supervision and interpretation included. This is a specialized endovascular procedure used in venous reconstruction and management of venous occlusive disease, and it matters nationally because it reflects growing use of minimally invasive techniques to treat complex venous pathology and can affect facility and professional payment policies across payers. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context for using CPT code 37239, typical sites of service where the procedure is performed, common billing modifiers and coding considerations, and how major payers address coverage and payment for secondary venous stent placements. The summary also highlights related billing and documentation requirements and points readers to typical policy levers that influence authorization and reimbursement. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37239CPTvenous stentendovascularinterventional radiologyoutpatient surgeryhospital outpatientstent insertionvascular procedure

Billing Code Overview

CPT code 37239 describes insertion of an intravascular stent in a vein using a catheter after stent placement in a separate vein. The service includes radiological supervision and interpretation and may be performed through either open surgical access or percutaneous vascular access.

Service type: Endovascular venous stent placement (secondary stent insertion)
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in an interventional radiology suite or hybrid operating room depending on clinical needs and access approach.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic venous stenosis or occlusion in the central or peripheral venous system (for example post-thrombotic iliac vein stenosis or dialysis access-related outflow stenosis) who previously underwent stent placement in a separate vein and now requires placement of an additional stent in another vein. The patient is evaluated in the outpatient vascular clinic or inpatient vascular service with symptoms such as limb swelling, pain, recurrent edema, or dysfunction of an arteriovenous dialysis fistula. Pre-procedure workup includes focused venous duplex ultrasound and/or venography demonstrating restenosis or new stenosis in a different venous segment. Antiplatelet and anticoagulation status are reviewed and periprocedural informed consent is obtained.

During the procedure, vascular access is obtained either percutaneously (common femoral or jugular venous access) or via a limited open venous exposure when required. Under fluoroscopic guidance with radiological supervision and interpretation, the physician traverses the lesion with guidewires and catheters, performs angioplasty as needed, and deploys a stent in the target vein. Radiological supervision and interpretation are included in the service. Post-deployment venography confirms stent position and flow restoration. The patient is monitored in recovery and discharged with post-procedure instructions and follow-up imaging plans.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

CPT 37268: Additional Femoral/Popliteal Vessel Stent Placement During Same Session

CPT-37281-TIBIAL-PERONEAL-ANGIOPLASTY-ADDITIONAL-VESSEL

CPT 37281: Angioplasty of Additional Tibial/Peroneal Vessel

CPT-37279-FEMORAL-POPLITEAL-INTRAVASCULAR-LITHOTRIPSY

CPT 37279: Intravascular Lithotripsy During Femoral/Popliteal Revascularization

CPT-37266-COMPLEX-FEMORAL-POPLITEAL-ANGIOPLASTY-ADD-ON

CPT 37266: Complex Femoral/Popliteal Angioplasty (Add-on)

CPT-37249-PERIPHERAL-VEIN-BALLOON-ANGIOPLASTY-ADDITIONAL-VEINS

CPT 37249: Peripheral Vein Balloon Angioplasty, Additional Veins

CPT-37259-ILIAC-ARTERY-STENT-PLACEMENT-ADDITIONAL-VESSEL

CPT 37259: Iliac Artery Stent Placement, Additional Vessel

CPT-37282-TIBIAL-PERONEAL-ANGIOPLASTY-COMPLEX-OCCLUSION

CPT 37282: Angioplasty of Complex Tibial/Peroneal Occlusion

CPT-37292-TIBIAL-PERONEAL-STENT-AND-ATHERECTOMY-REVASCULARIZATION

CPT 37292: Tibial/Peroneal Revascularization with Stent and Atherectomy

CPT-37256-ILIAC-ARTERY-COMPLEX-LESION-ANGIOPLASTY

CPT 37256: Angioplasty for Complex Iliac Artery Occlusion

CPT-37280-TIBIAL-PERONEAL-ANGIOPLASTY-BALLOON-ANGIOPLASTY

CPT 37280: Tibial/Peroneal Balloon Angioplasty, Single Lesion

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Taxonomy Code	Specialty	Notes
208800000X	Vascular Surgery	Primary specialty performing venous stent placements and endovascular interventions.
207P00000X	Interventional Cardiology	Performs endovascular venous procedures in some centers.
207K00000X	Interventional Radiology	Common specialty providing fluoroscopic-guided venous stenting and radiological interpretation.
2080P0005X	General Surgery - Vascular	Vascular-trained general surgeons who perform these procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	Acute DVT can lead to venous obstruction requiring stent placement after thrombosis resolution or in chronic sequelae.
`I82.402`	Acute embolism and thrombosis of unspecified deep veins of left lower extremity	Same clinical relevance for left-sided venous disease.
`I87.2`	Venous insufficiency (chronic) (peripheral)	Chronic venous insufficiency with reflux and obstruction can require endovascular stenting of obstructive lesions.
`I82.403`	Acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities	Bilateral disease may necessitate staged or multiple venous interventions including separate-vein stent placement.
`T82.854A`	Embolism and thrombosis of vascular prosthetic device, initial encounter	Prior stent or prosthetic device complications may require treatment in a separate vein or revision with additional stent placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37238`	Transcatheter placement of intravascular stent(s), peripheral artery, initial vessel	Although focused on arterial stents, `37238` is conceptually related as the initial-per-vessel stent placement CPT family; not used for venous stents but referenced in endovascular coding.
`36010`	Introduction of non-tunneled centrally inserted central venous catheter; age 5 years or older	May be performed for central venous access prior to venous intervention when separate venous access is required.
`36147`	Introduction of catheter, inferior vena cava, with radiological supervision and interpretation; initial	May be used when IVC catheterization or filter procedures are performed in conjunction with venous interventions.
`37241`	Transcatheter placement of intravascular stent(s), venous, initial vein	Used for initial venous stent placement codes in the same family; may be performed on a different vein in staged interventions.
`35865`	Venography, by catheter, selective, radiological supervision and interpretation	Performed for diagnostic venography during planning or at the time of stent deployment.

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