2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 1-2026 PCI LER Iliac Brochure

2026 PCI LER Iliac Brochure

Pdf Summary

The document provides detailed guidance on CPT coding for Lower Extremity Revascularization procedures in the iliac vascular territory, as defined by the Society for Cardiovascular Angiography and Interventions (SCAI). It categorizes revascularization codes based on intervention type (endovascular, open, or percutaneous), lesion complexity (straightforward or complex), and whether transluminal angioplasty or stent placement is performed.<br /><br />Key CPT codes include:<br />- 37254-37257 for angioplasty alone (straightforward and complex lesions),<br />- 37258-37261 for stent placement combined with angioplasty,<br />- 37262 for intravascular lithotripsy (add-on code).<br /><br />Each code covers necessary steps such as arterial access, selective catheterization, lesion crossing, and all imaging guidance and radiological supervision related to the procedure. Interventions should be coded per vessel within the same territory, with primary codes used for each territory treated and add-on codes for additional vessels (up to two per leg). Stent placement codes are reported once per vessel, regardless of the number of stents. Procedures on each leg are reported separately; modifier 59 denotes distinct procedures, and modifier 50 is used for bilateral procedures.<br /><br />The document emphasizes that lesions crossing multiple territories treated with a single therapy require only one code. It also clarifies that interventions are coded per vessel, not per lesion, and that procedures such as iliac atherectomy and diagnostic angiography have separate codes (e.g., 0238T for atherectomy). The lithotripsy add-on code (37262) can be reported up to three times per leg.<br /><br />Lower Extremity Revascularization encompasses several components: access, catheterization, lesion crossing, embolic protection, arteriotomy closure, radiologic supervision, imaging to confirm completion, and associated diagnostic codes performed through the same access site.<br /><br />The document serves as a consensus guideline for proper CPT coding in iliac territory revascularization but advises consultation with legal counsel for specific cases and reimbursement issues.

Keywords

CPT coding

Lower Extremity Revascularization

iliac vascular territory

endovascular intervention

angioplasty

stent placement

intravascular lithotripsy

lesion complexity

modifier 59

modifier 50