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Official Description

Transcatheter biopsy

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 37200 refers to a transcatheter biopsy, a minimally invasive procedure used to obtain tissue samples from within a blood vessel. This procedure is typically performed when there is a need to diagnose conditions affecting the vascular system. The process begins with the selection and exposure of the access vessel, which is the blood vessel through which the biopsy will be performed. A small incision, or nick, is made in the vessel to facilitate the insertion of an introducer sheath, a tube that allows for the passage of instruments into the vessel. Following this, a guidewire is carefully advanced to the specific site of the biopsy, guided by imaging techniques that provide radiological supervision and interpretation. Once the guidewire is in place, a biopsy catheter is threaded over it, allowing for the withdrawal of the guidewire. The catheter is then used to obtain a tissue sample from the lumen of the blood vessel, which is crucial for further analysis. After the tissue sample is collected, the biopsy catheter is removed, and the sample is sent to a laboratory for histological analysis, which is a separate reportable service. Finally, the blood vessel is repaired to ensure proper healing and restore normal function.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The transcatheter biopsy procedure is indicated for various clinical scenarios where tissue diagnosis is necessary. The following conditions may warrant the performance of this procedure:

  • Vascular lesions - When there are abnormalities or suspected tumors within the blood vessels that require histological confirmation.
  • Unexplained vascular symptoms - In cases where patients present with symptoms such as unexplained bleeding or obstruction, and a tissue diagnosis is needed to guide treatment.
  • Monitoring of known vascular conditions - For patients with previously diagnosed vascular diseases, a biopsy may be necessary to assess the progression or response to treatment.

2. Procedure

The transcatheter biopsy procedure involves several critical steps to ensure successful tissue acquisition. The following outlines the procedural steps:

  • Step 1: Access Vessel Selection - The procedure begins with the careful selection of the appropriate access vessel, which is typically a peripheral artery or vein. The vessel is then exposed to allow for direct access.
  • Step 2: Vessel Nicking and Sheath Insertion - A small incision, or nick, is made in the selected blood vessel. An introducer sheath is then inserted into the vessel, providing a pathway for the subsequent instruments needed for the biopsy.
  • Step 3: Guidewire Advancement - Utilizing radiological supervision and interpretation, a guidewire is advanced through the introducer sheath to the designated biopsy site. This step is crucial for accurately positioning the biopsy catheter.
  • Step 4: Biopsy Catheter Insertion - A biopsy catheter is advanced over the guidewire, which is then withdrawn. The catheter is designed to facilitate the collection of tissue samples from the blood vessel lumen.
  • Step 5: Tissue Sample Acquisition - Once the biopsy catheter is in place, a tissue sample is obtained from the lumen of the blood vessel. This sample is essential for histological analysis.
  • Step 6: Catheter Removal and Sample Processing - After the tissue sample is collected, the biopsy catheter is removed. The obtained tissue sample is then sent to a laboratory for histological analysis, which is a separately reportable service.
  • Step 7: Vessel Repair - The final step involves repairing the blood vessel to ensure proper healing and restore normal blood flow.

3. Post-Procedure

Post-procedure care following a transcatheter biopsy is essential for patient recovery and monitoring. Patients may be observed for any signs of complications, such as bleeding or infection at the access site. It is important to ensure that the blood vessel has healed properly and that normal function is restored. Follow-up appointments may be scheduled to discuss the results of the histological analysis and to determine any further treatment based on the findings. Patients should also be advised on activity restrictions and signs to watch for that may indicate complications.

Short Descr TRANSCATHETER BIOPSY
Medium Descr TRANSCATHETER BIOPSY
Long Descr Transcatheter biopsy
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 2
CCS Clinical Classification 62 - Other diagnostic cardiovascular procedures

This is a primary code that can be used with these additional add-on codes.

37252 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
37253 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)
GC This service has been performed in part by a resident under the direction of a teaching physician
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
CR Catastrophe/disaster related
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
1992-01-01 Added First appearance in code book in 1992.
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