There are many CPT codes for Angioplasty in vascular surgery coding. We will discuss the use of CPT code 37246, 37247, 37248 and 37249, which are used for angioplasty. These CPT codes describe angioplasty procedures in the aorta and the brachiocephalic (and branches), renal, visceral arteries and venous region. There are two initial and two add-on codes for both arteries and veins.

Today we focus more on the angioplasty procedure codes. So, let us check out more in detail about CPT codes 37246, 37247, 37248 and 37249. 

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Code description for Angioplasty CPT codes

We have two CPT codes for arteries and two CPT codes for venous angioplasty. CPT code 37246 and 37247 are used for coding arterial angioplasty and CPT code 37248 and 37249 are used for coding venous angioplasty. Below is the detail description of these four CPT codes.

37246 – Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery

+37247 – Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery (List separately in addition to code for primary procedure)

37248 – Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein

+37249 – Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure)

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As you can see above, we have an “initial” CPT code 37246 and an additional CPT code 37247 for more than one angioplasty in arteries. Same goes with veins, CPT code 37248 is used for initial angioplasty and CPT code 37248 is used for each additional venous angioplasty.

Do and Don’t of CPT code 37246, 37247, 37248 and 37249

These CPT codes of angioplasty and venoplasty  include utilization of both percutaneous and open approaches

Do not use codes 37246-37249 for treatment of stenoses in the dialysis circuit when accessed via the dialysis circuit. We have separate new CPT codes from 36901-36907 for coding such procedures. Use CPT codes 37246-37249 only for the vessels treatment outside of the dialysis circuit.

The venous angioplasty codes apply to all venous structures including portal and mesenteric venous structures. Even for venoplasty of Pulmonary vein stenosis, we can use CPT code 37248 and 37249.

Coding tips

Add-on codes are never reported as stand-alone codes and should always accompany the parent code.

Codes 37246, 37247, 37248, and 37249 describe transluminal balloon angioplasty outside the lower extremities for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, coronary arteries, or dialysis circuit

Codes 37246-37249

• All balloon angioplasty performed in the treated vessel, including any pre-dilation.
• Radiological supervision and interpretation directly related to the intervention performed.
• Closure of the arteriotomy by pressure.

Do not code angioplasty for treatment of same vessel, that has already been treated with stent placement.

Angioplasty CPT codes are coded per vessel and not per lesion. Hence, for multiple angioplasty in same vessel will be reported with only one single CPT code.

Do not code these angioplasty CPT codes for lower extremity region. We have separate CPT codes for angioplasty, stent and atherectomy procedures for lower extremity.

Codes 37246-37249 exclude (separately reportable)

• Non-selective and/or selective catheterization (unlike in the lower extremity where the catheterization is bundled).
• Extensive repair or replacement of an artery (eg, 35226, 35286, 35371).
• Ultrasound guidance (eg, 76937) for vascular access.
• Intravascular ultrasound (ie, 37250, 37251).
• Initial diagnostic angiogram (as defined under “vascular procedures” in the Radiology section of the CPT code set)