Codes 37252 and 37253
describe the service of IVUS in a vessel during a single encounter, including the introduction and manipulation of the probe into the vessel, imaging guidance for the IVUS portions of the procedure, and radiologic supervision and interpretation for the IVUS. These codes do not include vessel catheterization or diagnostic angiography, which may be separately reported.
Each code is an add-on code, meaning that it must be reported with a primary procedure code. The primary procedure(s) may be diagnostic angiography and/or interventional procedures. A vessel catheterization code (eg, 36005, 36200, 36245) may be the primary/base code for IVUS. Code 37252 is reported once per procedure for the first vessel studied with IVUS. Code 37253 may be reported for each additional vessel studied during the procedure and may be reported more than once if multiple additional vessels are studied. Each code is reported only once for all IVUS performed in that vessel during the entire procedure. IVUS performed as part of the diagnostic study, during an intervention to monitor progress of the intervention, and at the completion of the intervention to document completion would be reported only once for a single vessel. In addition, if a single pathology extends across more than one vessel, the IVUS code would be reported for a single vessel. For example, in a case of extensive lower extremity deep vein thrombosis extending from the popliteal vein through the inferior vena cava, IVUS of the entire thrombosed segment would be reported as a single vessel, and 37252 would be reported once regardless of how many times the IVUS probe was introduced and used to monitor progress of the intervention.
A few existing interventional CPT codes specifically include IVUS, so that IVUS may not be reported in addition to these services: vena cava filter insertion, repositioning, or retrieval (ie, 37191, 37192, 37193) and intravascular foreign body retrieval (37197).
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37252
IVUS (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiologic supervision and interpretation; initial noncoronary vessel
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37253
each additional noncoronary vessel
A review of changes in CPT coding for interventional procedures effective January 2016.
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