Clinical Context
A 72-year-old male with smoking history, peripheral arterial disease, and lifestyle-limiting right calf claudication is referred to vascular surgery after noninvasive testing demonstrates a hemodynamically significant stenosis of the right superficial femoral artery (SFA). During the same session as an initial femoral revascularization (open or percutaneous) to treat the primary lesion in the SFA, the interventionalist identifies a second, straightforward focal stenosis in the profunda femoris artery within the femoral/popliteal vascular territory. The provider performs balloon angioplasty of that additional lesion during the same anesthetic encounter.
Pre-procedure workflow includes vascular lab imaging, medication reconciliation (antiplatelet and anticoagulation assessment), informed consent specific to endovascular femoral/popliteal interventions, and planning of access site (common femoral artery access or open cutdown). Intra-procedure steps include arterial access, catheter and sheath placement, lesion crossing, selective angiography for lesion characterization, balloon dilation of the additional vessel, and completion angiography. Post-procedure workflow includes hemostasis management, monitoring for access complications, assessment of distal perfusion, discharge instructions regarding antiplatelet therapy and wound care, and scheduling follow-up vascular clinic and duplex surveillance.
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 | May be performed if angioplasty alone is insufficient and a stent is required in the primary treated vessel. |
37267 | Transcatheter placement of an intravascular stent(s), peripheral artery, with atherectomy when performed; initial vessel | Performed when plaque debulking (atherectomy) is needed in conjunction with stent placement during the revascularization session.
37225 | Revascularization, endovascular, open or percutaneous, femoral/popliteal, initial vessel; with transluminal angioplasty | Represents the initial femoral or popliteal revascularization service commonly reported with 37264 for the additional vessel in the same session.
36011 | Introduction of needle or intracatheter, arterial, cutdown, not including imaging guidance | May be reported for arterial cutdown access techniques when performed separately from percutaneous access.
76937 | Ultrasound guidance for vascular access (e.g., duplex ultrasound) | Used when real-time ultrasound guidance is used for arterial access prior to angioplasty or revascularization.