Endovascular procedures have transformed vascular care by offering minimally invasive solutions for conditions such as peripheral artery disease (PAD), aneurysms, and arterial blockages. While these procedures improve patient outcomes and reduce recovery times, they also introduce a new level of complexity in medical billing.
For healthcare providers and billing teams, endovascular CPT codes can be challenging due to bundled services, component coding rules, imaging inclusions, and frequent payer-specific requirements. Even small coding mistakes may lead to denials, underpayments, or compliance risks.
This guide explains endovascular CPT coding in detail and highlights how partnering with an experienced medical billing company like Allzone can ensure accuracy, faster reimbursements, and fewer denials.
What Are Endovascular Procedures?
Endovascular procedures are minimally invasive techniques performed inside blood vessels using catheters, wires, balloons, and stents. These procedures are commonly used to:
- Treat peripheral artery disease (PAD)
- Repair aneurysms
- Remove blood clots
- Open blocked vessels
- Improve blood flow in limbs or organs
Because multiple steps are often performed during a single session—such as catheter placement, imaging, angioplasty, and stenting—proper CPT coding is critical to capture the full value of services rendered.
Understanding Endovascular CPT Coding Structure
Endovascular coding is primarily reported using:
-
- CPT codes (Current Procedural Terminology)
- Bundled/component codes
- Add-on codes
- Selective catheterization codes
Many services are bundled together under comprehensive codes, meaning you cannot bill separately for certain components like imaging or supervision.
Coders must understand:
-
- Vessel hierarchy
- Laterality (right/left/bilateral)
- Selective vs. non-selective catheterization
- Bundled vs. separately reportable services
Missing any of these details can reduce reimbursement.
Key Categories of Endovascular CPT Codes
Let’s break down the most commonly used code groups.
-
Catheter Placement Codes (36200–36248)
Catheter placement is often the first step in endovascular procedures. Coding depends on how selective the catheter placement is.
Examples:
- 36200 – Non-selective catheter placement
- 36245 – First-order selective arterial catheterization
- 36246 – Second-order
- 36247 – Third-order or beyond
👉 Important Tip:
Only the highest level of selectivity per vascular family is reported. Lower-level placements are bundled.
2. Diagnostic Angiography Codes (75600–75774)
These codes describe imaging studies performed to evaluate blood vessels.
Examples:
- 75625 – Aortography
- 75710 – Extremity angiography
- 75716 – Bilateral extremity imaging
👉 Coding Rule:
Diagnostic angiography can be billed separately only if medically necessary and not already included in an intervention.
If imaging is done solely to guide treatment, it is usually bundled.
-
Angioplasty Codes
Angioplasty opens narrowed vessels using a balloon.
Common codes:
- 37220–37235 – Lower extremity angioplasty/stent procedures
- 37224 – Femoral/popliteal angioplasty
- 37225–37227 – With stent placement
These codes are territory-based, not per vessel.
👉 This means:
You bill once per vascular territory even if multiple lesions are treated.
-
Stent Placement Codes
Stents keep vessels open after angioplasty.
Examples:
- 37236 – Initial arterial stent
- 37237 – Each additional stent
- 37238–37239 – Venous stents
👉 Many stent codes already include:
- Catheterization
- Imaging guidance
- Angioplasty
Avoid double billing.
5. Atherectomy Codes
Atherectomy removes plaque buildup.
Examples:
- 37225–37227 – Lower extremity atherectomy codes
These are also territory-based and bundled.
👉 If atherectomy and angioplasty occur together, only the comprehensive code should be billed.
6. Embolization Codes
Used to block blood vessels for bleeding control or tumor management.
Examples:
- 37241–37244 – Embolization procedures
These codes often include:
- Catheterization
- Imaging
- Follow-up angiography
Common Endovascular Coding Challenges
Endovascular coding is complex because:
Bundling Rules
Many services are packaged together. Billing separately may cause denials.
Territory-Based Reporting
Lower extremity interventions are billed per territory, not per lesion.
Modifier Usage
Modifiers like:
- -59
- -LT/-RT
- -XS
may be needed to distinguish separate services.
Documentation Gaps
Missing documentation of:
- Vessel order
- Laterality
- Medical necessity
- Lesion details
can lead to rejected claims.
Best Practices for Accurate Coding
Healthcare providers can reduce errors by following these strategies:
1. Improve Clinical Documentation
Ensure physicians document:
-
- Vascular family treated
- Selectivity level
- Laterality
- Interventions performed
- Diagnostic vs. therapeutic intent
2. Stay Updated on CPT Changes
Endovascular codes are frequently revised. Annual updates are critical.
3. Use Certified Coders
Certified vascular coders understand complex bundling and compliance rules.
4. Conduct Regular Audits
Internal audits help identify:
- Under-coding
- Over-coding
- Missed charges
- Denial trends
How Allzone Simplifies Endovascular Billing
Managing endovascular coding in-house can strain staff and increase denials. That’s where Allzone Management Services makes a difference.
Our expert vascular coding and billing team provides:
✔ Certified coders with specialty expertise
✔ Accurate CPT and ICD-10 assignment
✔ Documentation review
✔ Denial management
✔ Compliance monitoring
✔ Faster claim submissions
✔ Higher reimbursement rates
By outsourcing to Allzone, providers reduce administrative burden and focus on patient care while we handle the complexity of revenue cycle management.
Final Thoughts
Endovascular procedures offer clinical benefits, but their coding complexity demands precision. From selective catheter placement to bundled angioplasty and stent codes, every detail matters.
Incorrect coding can mean:
- Lost revenue
- Delayed payments
- Increased audits
- Compliance risks
Understanding CPT Guidelines and partnering with experienced billing professionals ensures optimal reimbursement and fewer denials.
If your practice performs vascular or interventional radiology procedures, now is the time to strengthen your coding strategy.
Need Help With Endovascular Billing?
Allzone Management Services specializes in endovascular and vascular surgery billing solutions that maximize revenue and reduce claim denials.
👉 Contact us today to streamline your endovascular coding and boost reimbursements.