Best Coding tips for CPT code 37215, 37216, 37217, 37218, 61635 and 61645

If you really want to be more accurate in stent procedure coding, you just need to remember two major points while coding stent placement CPT codes. First, medical coder should not code a separate radiological supervision and interpretation (RS&I) code with the main CPT code. The RS&I codes are included with main Stent placement CPT code. Also, do remember, the angioplasty procedure pre or post deployment, which were earlier coded separately, are also now included in the stent placement CPT codes when performed in same vessel. We have learned a lot about angiography coding, Transcatheter thrombolysis procedure codes or breast incision and excision biopsy, but coding stent procedure is not much from these exams. Interventional radiology (IVR) coders who are frequently stent procedures will be aware of these changes in Stent coding.  Before we go ahead do check the new CPT codes changes for 2017 as well.

Best Coding tips for CPT code 37215, 37216, 37217, 37218, 61635 and 61645


CPC Practice Exam - Medical Coding Study Guide Please Click Here!


Point to remember for coding Stent placement CPT codes


Stent placement codes are coded per vessel and/or per lesion treated. We have learned about lower extremity stent placement cpt codes previously. The same guidelines follows here as well. Even, when the physician is placing multiple stent in a single vessel, we have to assign or report only one CPT code for one single blood vessel.  Same goes with the lesion, even if you encounter multiple lesion or continuous lesion present on two or more vessel, we have to report only one CPT code for stent placement.

All the minor exams from taking access for placing stent to post stent placed angiography procedures, all are included in the stent placement CPT codes. Hence, do not code any minor exam separately. Do not code and angiography or RS&I code separately while coding stent exams.


When to code CPT code 37215 and 37216

Stent placement in Cervical carotid region is report with CPT code 37215 and 37216. Below is the code description of both these codes.

37215 Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection

37216           without distal embolic protection

Both the above CPT codes include angioplasty when performed on same vessel. When a distal embolic protection device is used to remove debris, report CPT code 37215 and when the device is absent use CPT code 37216.

Both 37215 and 37216 include ipsilateral cervical and cerebral diagnostic imaging; however, when imaging is performed of the head/neck vessels on the contralateral side, where a stent is not placed, report diagnostic angiography for imaging of those vessels.

When to code CPT code 37217 and 37218


Stent placement in common carotid artery or the innominate/brachiocephalic artery is reported with CPT code 37217 and 37218. Both, these CPT codes differ in the antegrade and retrograde approach for the placement of the stent in t this region. Below is the code description for both these CPT codes.

37217 Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation

37218 Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation

Use these codes to report stent placement in the portion of the common carotid artery from its origin, prior to entering the neck. CPT code 37217 and 37218 both includes angioplasty for stent placement when performed in the same vessel. Code 37217 describes stent placement via an open cervical carotid artery exposure. Assign 37218 for stent placement via an open or percutaneous antegrade approach. This is commonly performed via transfemoral access:

The provider may place a stent into the right brachiocephalic/ innominate artery via retrograde access of the ipsilateral brachial or axillary artery. In these instances, report 37236 (instead of 37218) because the procedure was not performed via antegrade approach. Open vessel exposure, closure of vessel, and ipsilateral cervical and cerebral diagnostic imaging are bundled into 37217 and 37218. If imaging is performed of the head/neck vessels on the contralateral side where a stent is not placed, report diagnostic angiography for imaging of those vessels.

When to code CPT code 61635 and 61645


Stent placement in the intracranial region is reported with CPT code 61635 and 61645.

61635 Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed

Code 61635 describes stent placement into an intracranial vessel. Intracranial vessels are within the skull and supply the brain. A portion of the internal carotid artery is considered extracranial, so be careful when selecting a code for stenting of the internal carotid artery.

CPT code 61635 includes all the selective catheterization procedures codes and imaging used for placing the stent. Also the radiological supervision and interpretation are included in CPT code 61635.


If imaging is performed of the head/neck vessels on the contralateral side, where a stent is not placed, report diagnostic angiography of those vessels.

Code 61635 also bundles angioplasty with stent placement in the same vessel. 61645 Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)

Code 61645 describes intracranial thrombectomy and/or infusion.


Do not report 61635 with 61645 for the same vascular territory. CPT 2016 states, “Code 61645 describes endovascular revascularization of thrombotic/embolic occlusion of intracranial arterial vessel(s) via any method, including mechanical thrombectomy (eg, mechanical retrieval device, aspiration catheter) and/or the administration of any agents(s) for the purpose of revascularization …” Report 61645 over 61635 for the same vascular territory.

Share this

Related Posts

Previous
Next Post »