2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 2-Slides: Dr. Osama Ibrahim

Slides: Dr. Osama Ibrahim

Pdf Summary

This document summarizes upcoming CPT code changes for Below the Knee (BTK) vascular interventions, specifically introducing new infra-malleolar (inframalleolar) revascularization codes effective in 2026. The infra-malleolar segment interventions are a new category covered by multiple interventional specialties, reflecting evolving practices in endovascular procedures.<br /><br />Key points include the introduction of a new set of CPT codes for revascularization procedures in the infra-malleolar vascular territory. These codes distinguish between straightforward lesions (stenosis) and complex lesions (occlusions), with primary/base codes assigned per treated vessel territory and add-on codes for additional vessels treated within the same leg.<br /><br />The new procedure codes cover angioplasty with detailed guidance that all associated maneuvers (artery access, catheterization, lesion crossing, imaging, and supervision) are included in the coding. The pedal arch only receives separate coding if it is the only vessel treated. Interventions are reported per vessel rather than per lesion, and coders should document accordingly in angiography reports.<br /><br />The document compares current CPT codes with the proposed new ones and their Relative Value Units (RVUs), noting some changes in RVU valuation. For example, infra-malleolar angioplasty will have codes 37296/37298, with RVUs of 11.00 and 13.70 respectively, based on lesion complexity.<br /><br />Add-on codes 37297 and 37299 allow billing for additional vessels treated within the infra-malleolar territory, with a maximum of one add-on code per leg allowed.<br /><br />The emphasis is on ensuring documentation and indications align with the use of these new codes to accurately reflect procedures performed and maintain compliance.<br /><br />Overall, these changes reflect a refined and more granular coding framework for BTK revascularization, aiming to improve reporting accuracy, clinical detail, and reimbursement aligned with the complexity of infra-malleolar vascular interventions.

Keywords

CPT code changes

Below the Knee (BTK) interventions

infra-malleolar revascularization

endovascular procedures

angioplasty coding

lesion complexity

add-on codes

Relative Value Units (RVUs)

vascular intervention documentation

2026 coding updates