CPT 37252 Intravascular Ultrasound Reimbursement | OpenPayer

Summary & Overview

CPT 37252: Intravascular Ultrasound for Noncoronary Vessel

CPT code 37252 denotes intravascular ultrasound (IVUS) performed as an add-on for the first noncoronary vessel examined during a diagnostic or interventional vascular procedure. IVUS provides cross-sectional, real-time imaging of the vessel lumen and wall by advancing a catheter-mounted ultrasound transducer into the vessel. This code is used when IVUS guidance and radiologic supervision and interpretation are part of procedures such as peripheral stent placement to treat obstruction or stenosis. Nationally, accurate reporting of IVUS add-on services affects clinical documentation, billing consistency, and tracking of advanced image-guided vascular care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context for IVUS in noncoronary vascular interventions, common billing considerations, and the role of this add-on code in procedure reporting. Readers will find benchmarks and coding guidance for proper use of the add-on descriptor, summaries of payer coverage focus areas, and relevant policy considerations that influence reimbursement and utilization monitoring. Data not available in the input for specific payer policies, fee schedules, or procedure volumes is indicated where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37252CPTintravascular ultrasoundIVUSvascular interventionimage-guidedinterventional radiologyendovascular

Billing Code Overview

CPT code 37252 describes an intravascular ultrasound (IVUS) evaluation performed as an add-on procedure for the first noncoronary vessel examined during a diagnostic or interventional therapeutic vascular procedure. In this service the provider inserts a catheter with an ultrasound transducer into the target vessel to send and receive high-frequency sound waves and visualize the vessel lumen and wall in real time. The description specifies that radiologic supervision and interpretation of the intravascular ultrasound are included in the service.

Service type: Image-guided vascular diagnostic or interventional procedure (intravascular ultrasound)
Typical site of service: Hospital catheterization lab or interventional radiology suite (procedural/inpatient or outpatient vascular procedure setting)

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with progressive left lower extremity claudication and imaging-confirmed peripheral arterial disease presents for endovascular intervention. After diagnostic angiography demonstrates a significant stenosis of the superficial femoral artery, the vascular interventionalist plans percutaneous transluminal angioplasty and possible stent placement. During the procedure, the provider inserts an intravascular ultrasound catheter to directly visualize vessel lumen, plaque burden, stent apposition, and true lumen size to guide stent sizing and optimize deployment. The procedure is performed in an outpatient endovascular suite or hospital catheterization laboratory under moderate sedation or monitored anesthesia care. Radiologic supervision and interpretation are performed and documented by the attending interventionalist or vascular surgeon, with procedural notes describing catheter insertion, image acquisition, measurements, and any therapeutic maneuvers informed by the intravascular ultrasound findings.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the physician’s interpretation and report when the facility bills the technical component separately
`59`

CPT 37285: Tibial/Peroneal Artery Stent Placement, Add-on

CPT-37290-TIBIAL-PERONEAL-ATHERECTOMY-OCCLUSION

CPT 37290: Atherectomy for Tibial/Peroneal Occlusion

CPT-37287-TIBIAL-PERONEAL-STENT-PLACEMENT-ADDITIONAL-VESSEL

CPT 37287: Tibial/Peroneal Stent Placement During Index Revascularization

CPT-37284-TIBIAL-PERONEAL-STENT-PLACEMENT-ANGIOPLASTY

CPT 37284: Tibial/Peroneal Stent Placement with Angioplasty

CPT-37257-ILIAC-ANGIOPLASTY-COMPLEX-LESION-ADDITIONAL-VESSEL

CPT 37257: Iliac Angioplasty for Complex Lesion in Additional Vessel

CPT-37269-FEMORAL-POPLITEAL-COMPLEX-OCCLUSION-STENT-PLACEMENT

CPT 37269: Stent Placement for Complex Femoral-Popliteal Occlusion

CPT-37276-ATHERECTOMY-STENT-FEMORAL-POPLITEAL-ADDITIONAL-VESSEL

CPT 37276: Atherectomy and Stent Placement in Additional Femoral/Popliteal Vessel

CPT-37274-FEMORAL-POPLITEAL-ATHERECTOMY-ADDITIONAL-VESSEL-OCCLUSION

CPT 37274: Femoral/Popliteal Atherectomy for Complex Occlusive Lesion

CPT-37267-FEMORAL-POPLITEAL-STENT-PLACEMENT

CPT 37267: Femoral and Popliteal Arterial Stent Placement

CPT-37299-INFRAMALLEOLAR-ANGIOPLASTY-ADDITIONAL-COMPLEX-LESION

CPT 37299: Inframalleolar Angioplasty for Complex Lesion

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Taxonomy Code	Specialty	Notes
207K00000X	Vascular Surgery	Common performing specialty for peripheral endovascular interventions
207P00000X	Interventional Radiology	Frequently performs IVUS during image-guided vascular procedures
2084P0800X	Interventional Cardiology	May perform IVUS when trained in peripheral endovascular procedures
363L00000X	Vascular Medicine	Sometimes involved in endovascular planning and interpretation
207L00000X	General Surgery	Vascular-focused general surgeons performing peripheral interventions

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities, unspecified, bilateral	Peripheral arterial atherosclerotic disease causing stenosis amenable to endovascular intervention guided by IVUS
`I70.209`	Atherosclerosis of native arteries of the extremities, unspecified extremity	Common indication for angioplasty/stenting where IVUS assists in lesion assessment and stent sizing
`I74.3`	Embolism and thrombosis of arteries of lower extremity	Acute or subacute thromboembolic disease where IVUS can evaluate residual lumen and guide therapy
`I73.9`	Peripheral vascular disease, unspecified	Broad diagnosis under which IVUS may be used to characterize lesion severity in symptomatic patients
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	Less common, but may require intravascular imaging during interventional procedures for venous pathology
`T82.898A`	Other complications of vascular prosthetic devices, implants and grafts, initial encounter	Used when IVUS evaluates graft or stent complications such as restenosis or malapposition
`Z98.890`	Other specified postprocedural states	Represents prior vascular procedures with follow-up IVUS assessment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37246`	Transcatheter placement of intravascular stent(s), peripheral artery, open or percutaneous, including angioplasty when performed; initial vessel	Often performed immediately before or after IVUS to treat a peripheral arterial stenosis; IVUS guides stent sizing and placement
`36215`	Selective catheter placement, arterial branch, within the same vascular family (e.g., extremity, visceral), radiologic supervision and interpretation	May be used to access the target peripheral vessel prior to IVUS catheter insertion
`75710`	Angiography, extremity, unilateral, radiological supervision and interpretation	Diagnostic angiography commonly performed in the same session to define lesion anatomy; IVUS complements angiographic imaging
`93571`	Intravascular coronary ultrasound, for coronary arteries (note: coronary code for contrast)	Related technology code for coronary IVUS (distinct from noncoronary `37252`) to clarify coding differences
`99152`	Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes)	Sedation or monitored anesthesia care is commonly reported separately when provided for peripheral endovascular procedures

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