Summary & Overview
CPT 37297: Inframalleolar Angioplasty for Additional Vessel, Straightforward Lesion
CPT code 37297 captures angioplasty performed for a straightforward stenotic lesion in an additional inframalleolar vessel during the same session as an initial inframalleolar revascularization. The code documents completion of all required procedural components — access, catheterization, lesion crossing, and imaging guidance — and applies whether the approach is open or percutaneous. Nationally, this code is relevant for hospitals, vascular surgery and interventional radiology practices, and payers managing limb salvage and peripheral arterial disease care pathways.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this adjunctive angioplasty is reportable, typical sites of service, and payer considerations that influence adjudication and coverage. The publication provides benchmarks for utilization, summarizes policy-relevant practice patterns, and outlines coding relationships to other inframalleolar and peripheral vascular services. It also highlights implications for procedure documentation and claims submission to support accurate coding and payment across major national payers.
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer policy language.
Billing Code Overview
CPT code 37297 describes angioplasty (balloon expansion of a narrowed area) performed during the same session as an initial inframalleolar revascularization service for a straightforward lesion in an additional vessel within the inframalleolar vascular territory. The inframalleolar territory includes the dorsalis pedis and plantar arteries. The service includes all access, catheterization, lesion crossing, and imaging guidance necessary to complete the procedure. The approach may be open or percutaneous.
Service Type: Endovascular or surgical inframalleolar angioplasty for an additional straightforward lesion
Typical Site of Service: Operating room, catheterization lab, or other procedural suite where inframalleolar revascularization is performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with diabetes mellitus and peripheral artery disease presents with rest pain and nonhealing ulceration of the forefoot. Noninvasive vascular testing and angiography during the initial inframalleolar revascularization session reveal a primary target lesion in one inframalleolar artery and a secondary, straightforward focal stenosis in the dorsalis pedis artery. The interventional vascular specialist performs the initial inframalleolar revascularization and, in the same session, performs balloon angioplasty of the additional straightforward lesion in the dorsalis pedis (inframalleolar) territory. The procedure includes arterial access, catheterization, lesion crossing, angiographic imaging, and balloon dilation. Typical sites of service are hospital-based catheterization laboratories or ambulatory vascular surgery centers. The clinical workflow includes patient consent and preprocedural assessment, vascular access (percutaneous or open), diagnostic angiography, treatment of the primary inframalleolar lesion, immediate angiographic evaluation of downstream vessels, and angioplasty of the additional straightforward inframalleolar lesion during the same anesthetic encounter, followed by hemostasis, postprocedural monitoring, and documentation of findings and devices used.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when a distinct E/M service is performed and documented on the same day as the procedure prior to the inframalleolar intervention. |