The clinical scenario involves a diagnostic angiography (not separately reportable in this case as the therapeutic intervention occurs in the same session and the diagnosis is already known) and a percutaneous transluminal angioplasty (PTA) with stent placement in the left iliac artery.
To code this correctly:
CPT Code 37267: Transluminal stent placement(s), includes angioplasty within the same vessel, when performed; iliac artery.
This code includes the angioplasty if it is performed in the same vessel as the stent (which is true here — both procedures are done in the left iliac artery).
Since angioplasty is inherent to the stenting (to open the narrowed vessel before stent placement), only the stent code is reported.
No need to report angioplasty separately (e.g., 37263) when performed in the same vessel as the stent.
Other options explained:
A. 37267, 37263 – Incorrect. 37263 (angioplasty in the iliac artery) would only be reported if angioplasty was done in a separate iliac artery segment without stenting. Reporting both codes for the same vessel would be unbundling and against CPT/NCCI guidelines.
B. 37258, 37254 – Incorrect. These codes relate to renal artery procedures, not iliac artery.
C. 37258 – Also incorrect, as this refers to renal stent placement, not iliac.
Official CPT® Guideline Reference:
In the CPT® manual (Category I codes, 37220–37235), specific instructions state that angioplasty is included when performed in the same vessel as a stent and should not be reported separately.
