CPT 2014 – Embolization and Occlusion

iStock_000007475145SmallThere are several new and revised CPT codes that will affect cardiologists and vascular surgeons in 2014.  In particular, we will see changes in how we code embolization in certain vessels.

The RUC Relativity Assessment Workgroup continues their mission of abandoning the component coding concept and bundling certain services into single codes based on their 75 percent rule.  For code pairs that are billed together greater than 75 percent of the time, new CPT codes are created that bundle multiple procedures into one single code.

The new CPT codes for embolization and occlusion are to be used for any procedure performed to permanently block or restrict blood or lymphatic fluid flow to an area.  CPT 37204 and 37210 have been deleted.  The new codes should not be used for embolization in vessels in the head, neck, brain, or spinal cord.  Other codes are available for those anatomic areas.

These embolization codes as noted in the CPT book “include all associated radiological supervision and interpretation, intra-procedural guidance and road-mapping, and imaging necessary to document completion of the procedure.  Code(s) for catheter placement(s) and diagnostic studies may be separately reportable using the appropriate diagnostic angiography codes with an appropriate modifier (eg, modifier 59).”  Code selection should be based on the indication for the procedure and the vessel involved.  Codes are reported per surgical field, not vessel treated.  For more information, you should refer to the introduction to this section of the CPT book.

37241 – Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)

37242 – arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)

37243 – for tumors, organ ischemia, or infarction

37244 – for arterial or venous hemorrhage or lymphatic extravasation

As mentioned above, catheter placement and diagnostic studies should be reported separately, but you may also report the following separately: 

  • Ultrasound guidance for vascular access
  • Administration of radiopharmaceuticals
  • Chemotherapy administration



CPT codes and their descriptors are copyright 2013 by the American Medical Association.