2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 2-Slides: Monica Wright

Slides: Monica Wright

Pdf Summary

The Society for Cardiovascular Angiography and Interventions (SCAI) provides updated guidance on CPT coding for lower extremity revascularization procedures, effective in 2026. The previous CPT codes 37220–37235 are replaced by 45 new codes categorized into four vascular territories: Iliac, Femoral Popliteal, Tibial Peroneal, and Inframalleolar.

Lower extremity vascularization procedures typically include artery access, selective catheterization, lesion crossing, radiologic supervision, embolic protection, arteriotomy closure, and imaging for completion documentation.

<strong>Tibial Peroneal Territory:</strong>
This includes anterior tibial, posterior tibial, and peroneal arteries. The tibioperoneal trunk is not coded separately unless it’s the only vessel treated. Initial interventions per vessel use primary/base codes (e.g., 37280, 37284, 37288, 37292) covering angioplasty, stenting, atherectomy, or combined procedures, classified by lesion complexity (straightforward or complex). Up to two add-on codes can be reported per limb for additional vessels. Coding is per vessel, not per lesion, using the most complex service performed. Bilateral procedures require modifier 50 for base codes and modifier 59 for add-on codes.

<strong>Inframalleolar Territory:</strong>
Includes dorsalis pedis and plantar arteries. The pedal arch is treated as a single vessel unless it is the sole vessel treated. Only two primary codes (37296, 37298) are used for the initial vessel, with one add-on code allowed per extremity. Similar principles of lesion complexity and vessel-based reporting apply.

Key coding principles include using one base code per vascular territory, reporting additional vessels with add-on codes, and applying modifiers for bilateral procedures. These updates aim to enhance specificity and accuracy in coding lower extremity endovascular revascularization.

Keywords

SCAI

CPT coding

lower extremity revascularization

vascular territories

Tibial Peroneal Territory

Inframalleolar Territory

angioplasty

stenting

atherectomy

calcium

laser

orbital

plaque

bilateral procedure modifiers