Summary & Overview
HCPCS C7564: Percutaneous Mechanical Thrombectomy of Vein(s) with Image Guidance
HCPCS Level II code C7564 denotes percutaneous transluminal mechanical thrombectomy of vein(s) that includes intraprocedural pharmacologic thrombolytic injections, fluoroscopic guidance, and intravascular ultrasound, with radiological supervision and interpretation. This code captures a complex endovascular venous intervention used in diagnostic evaluation and therapeutic management of venous thrombotic disease. Nationally, the procedure matters because it represents an advanced, resource-intensive treatment option that typically occurs in hospital outpatient departments, ambulatory surgical centers, or interventional radiology suites and involves multi-modality imaging and pharmacologic therapy.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, coding scope, and typical sites of service, followed by benchmark-oriented insights where available. The publication summarizes common billing modifiers and payer coverage considerations, highlights clinical scenarios where the code is applicable, and outlines items for operational attention such as documentation elements tied to image guidance and thrombolytic administration. Data not available in the input is noted where applicable.
This summary is intended for national healthcare policy, coding, and revenue cycle stakeholders seeking a clear, practical briefing on the use and administrative implications of C7564.
Billing Code Overview
HCPCS Level II code C7564 describes percutaneous transluminal mechanical thrombectomy of vein(s). The procedure includes intraprocedural pharmacological thrombolytic injections, fluoroscopic guidance, and intravascular ultrasound during diagnostic evaluation and/or therapeutic intervention, with radiological supervision and interpretation.
Service Type
- Endovascular mechanical thrombectomy with thrombolysis and image guidance
Typical Site of Service
- Hospital outpatient department
- Ambulatory surgical center
- Interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a 56-year-old male with acute unilateral lower extremity swelling, pain, and cyanosis after a recent prolonged immobilization and known history of deep vein thrombosis (DVT). Duplex ultrasound demonstrates extensive occlusive thrombus of the femoropopliteal and iliofemoral venous segments with threatened limb perfusion. The vascular surgery and interventional radiology teams evaluate the patient and determine that percutaneous transluminal mechanical thrombectomy with adjunctive intraprocedural pharmacologic thrombolysis and intravascular ultrasound (IVUS) guidance is indicated to rapidly restore venous outflow.
Pre-procedure workflow includes review of anticoagulation status, informed consent, baseline labs (CBC, coagulation panel, renal function), and anesthesia assessment for monitored anesthesia care. In the angiography suite, venous access is obtained (commonly popliteal or common femoral), diagnostic venography and IVUS are performed to delineate thrombus extent and underlying venous stenosis. Mechanical thrombectomy device deployment and pharmacologic thrombolytic infusion are performed under fluoroscopic guidance, with intermittent IVUS to confirm revascularization. Radiological supervision and interpretation are provided throughout. Post-procedure, the patient is monitored for bleeding, hemodynamic stability, and receives a venous duplex prior to discharge and coordination for anticoagulation management and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |