Summary & Overview
CPT 37619: Inferior Vena Cava Ligation to Narrow Vessel Diameter
CPT code 37619 designates surgical ligation of the inferior vena cava to narrow the vessel diameter using sutures or a clip. As an invasive vascular procedure, it is performed in operative settings and can be encountered in both inpatient and outpatient surgical environments depending on patient complexity. Nationally, this code captures discrete surgical management of venous injuries, hemorrhage control, or other indications requiring caval narrowing, and it affects hospital and surgeon billing and coding workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the billing implications of reporting CPT code 37619. The publication outlines available benchmarks where present, common modifier usage patterns from input data, and the clinical scenarios in which this procedure is documented. Where input data is incomplete, the text notes that specific items are not available in the input.
This summary is intended for coding professionals, surgical billing staff, and policy analysts seeking a national-level reference for CPT code 37619, its clinical role, and its place in hospital and professional billing processes.
Billing Code Overview
CPT code 37619 describes the surgical narrowing (ligation) of the inferior vena cava by tying the vessel with sutures or applying a clip. This procedure is performed to reduce the diameter of the vena cava for clinical reasons such as controlling venous flow or addressing complications related to venous injury or hemorrhage.
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Service type: Invasive vascular surgical procedure
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Typical site of service: Operating room or surgical suite (inpatient or outpatient surgical setting, depending on clinical circumstances)
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old with chronic venous insufficiency and recurrent, symptomatic deep venous thrombosis (DVT) of the lower extremity leading to significant venous stasis and risk of pulmonary embolism despite medical therapy. After vascular surgery evaluation, the team decides to perform inferior vena cava (IVC) narrowing (ligature or clip) to reduce caval diameter and improve venous outflow dynamics or to trap emboli when IVC filter placement is contraindicated or not feasible. The procedure is performed in an operating room or hybrid endovascular suite under general or monitored anesthesia care. The vascular surgeon exposes the infrarenal IVC via a transabdominal or retroperitoneal approach, encircles the cava, and places sutures or clips to achieve narrowing; intraoperative fluoroscopy or ultrasound may be used for localization. Typical workflow includes preoperative imaging (CT venography or duplex ultrasound), perioperative anticoagulation management, informed consent documenting risks (bleeding, infection, caval thrombosis), anesthesia induction, surgical exposure and narrowing, hemostasis, and postoperative monitoring in a recovery unit with early ambulation and anticoagulation plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician billing/standard service | Use when the provider is the primary surgeon performing the procedure without unusual circumstances. |