Summary & Overview
CPT 61642: Intracranial Angioplasty and Balloon Dilatation, Additional Vessel
CPT code 61642 denotes additional intracranial angioplasty and balloon dilatation performed on a second intracranial vessel in a different vascular territory after initial balloon dilatation for vasospasm. This code captures a distinct, same-session endovascular intervention targeting an additional territory and is relevant for hospitals and neurointerventional providers managing cerebral vasospasm complications following subarachnoid hemorrhage or other causes of vasospasm. Nationally, accurate use of this CPT code supports appropriate clinical documentation, claims adjudication, and resource planning for complex neuroendovascular care.
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 and service setting, typical billing considerations, and what to expect in payer coverage patterns and claim review. The publication highlights benchmarks for utilization and reimbursement where available, summarizes recent policy or coding guidance affecting intracranial angioplasty for vasospasm, and clarifies distinctions between initial and additional vessel procedures coded during the same session. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 61642 describes additional intracranial angioplasty and balloon dilatation performed to widen a second intracranial vessel in a different vascular territory after initial balloon dilatation of an intracranial vasospasm of one vessel. This procedure represents an endovascular intervention addressing intracranial vasospasm by performing angioplasty and balloon dilatation in a separate vascular territory from the initial treated vessel.
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Service type: Endovascular intracranial angioplasty and balloon dilatation for vasospasm
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Typical site of service: Hospital-based interventional radiology or neurointerventional suite, often during the same endovascular session as the initial procedure
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents after aneurysmal subarachnoid hemorrhage with delayed symptomatic cerebral vasospasm refractory to medical management (e.g., hypertensive, hypervolemic, hemodilution therapy and intra-arterial vasodilators). Diagnostic cerebral angiography identifies a focal severe vasospasm of a proximal middle cerebral artery branch in the left anterior circulation, and balloon angioplasty is performed to dilate that vessel. During the same session the interventional neurovascularist identifies significant focal vasospasm in a separate vascular territory (for example, a right internal carotid artery branch). The provider proceeds to perform additional intracranial angioplasty and balloon dilatation of that second vessel in a different vascular territory.
Workflow: The patient is taken to an angiography suite under monitored anesthesia care or general anesthesia. Vascular access (typically femoral or radial) is obtained, a diagnostic cerebral angiogram is performed, and vasospastic segments are identified. After balloon dilatation of the first intracranial vessel is completed, the operator repositions catheters and balloons to access a second vessel in a separate vascular territory and performs angioplasty/balloon dilatation during the same encounter. Hemostasis is achieved and the patient is monitored in an intensive care or step-down setting for neurological status and reperfusion complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier specified (default) |