Summary & Overview
CPT 37249: Peripheral Vein Balloon Angioplasty, Additional Veins
Headline: CPT code 37249: Peripheral vein balloon angioplasty for additional veins
Lead: CPT code 37249 covers endovascular balloon angioplasty performed in one or more additional peripheral veins (excluding the dialysis circuit) following angioplasty of an initial vein. The code bundles imaging guidance and radiological supervision and interpretation, reflecting a single-encounter, image-guided venous intervention.
What the code represents and why it matters: CPT code 37249 designates targeted balloon angioplasty of additional peripheral veins during the same session to restore patency and improve venous blood flow. It matters nationally because endovascular venous interventions are increasingly used to manage obstructive venous disease and complications of vascular access, and precise coding affects billing, quality measurement, and resource allocation across hospital outpatient and ambulatory settings.
Key payers covered: Analysis commonly addresses coverage and payment policies from Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Overview of what readers will learn: Readers will find clinical context for the procedure, typical sites of service, payer landscape and coverage considerations, coding relationships (including bundled imaging and RS&I), and benchmark-oriented policy updates where available. The publication clarifies what CPT code 37249 represents, the setting in which it is delivered, and the implications for billing and administrative workflows.
Data note: Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 diagnoses.
Billing Code Overview
CPT code 37249 describes an endovascular transluminal balloon angioplasty procedure performed on one or more additional peripheral veins (excluding the dialysis circuit) after an initial vein has already undergone angioplasty. The provider advances a balloon catheter into the lumen of the target vein(s) and inflates the balloon as many times and at as many points as necessary within the same vein to open the vessel and improve blood flow. The service includes all imaging guidance and diagnostic imaging necessary to perform the angioplasty and all radiological supervision and interpretation (RS&I).
Service type: Endovascular peripheral venous angioplasty (balloon), non-dialysis veins
Typical site of service: Hospital outpatient department, ambulatory surgery center, or interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of peripheral venous stenosis of the lower extremity presents with recurrent swelling and pain in the affected limb despite conservative measures. Venous duplex ultrasound demonstrates significant focal narrowing of a peripheral vein outside a dialysis circuit. The interventional radiology team schedules an endovascular venous angioplasty. Under moderate sedation in an outpatient vascular interventional suite, the operator gains percutaneous venous access, performs diagnostic venography with fluoroscopic imaging, and advances a balloon catheter into the target vein. After initial transluminal balloon angioplasty of the primary lesion, the provider advances the balloon catheter into one or more additional segments of the same or adjacent peripheral veins (excluding dialysis circuits) and performs serial dilatations as needed to restore luminal diameter and improve venous outflow. The procedure includes continuous imaging guidance, radiological supervision and interpretation (RS&I), and postprocedure venous imaging to document flow improvement. The patient is observed postprocedure and discharged with instructions for activity and follow-up with the vascular specialist.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct Procedural Service | Use when services that are normally bundled are performed in distinct anatomic sites or on different veins and documentation supports separate reporting. |