© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 37761 involves the ligation of perforator veins in one leg using an open subfascial technique. Perforator veins are critical structures that connect the deep venous system, specifically the femoral and popliteal veins, to the superficial saphenous veins in the legs. These veins can become incompetent, leading to chronic venous insufficiency, which is a condition characterized by poor blood flow and can result in venous ulcerations. The ligation procedure aims to treat these incompetent veins, thereby improving venous circulation and alleviating symptoms associated with venous insufficiency. The open subfascial technique allows for a more targeted approach, utilizing a smaller incision compared to other methods, and may incorporate ultrasound guidance to enhance the precision of locating and ligating the affected perforator veins. This technique is essential for ensuring that the ligation is performed effectively, minimizing complications, and promoting better recovery outcomes for patients suffering from severe venous issues.
© Copyright 2025 Coding Ahead. All rights reserved.
The ligation of perforator veins using CPT® Code 37761 is indicated for patients experiencing severe chronic venous insufficiency and associated venous ulcerations. This procedure is specifically performed to address the incompetence of perforator veins, which can lead to significant complications in venous circulation.
The ligation of perforator veins is performed through a series of well-defined steps to ensure effective treatment. The procedure begins with the patient being positioned appropriately to allow access to the affected leg. An incision is made along the medial calf, which is designed to be smaller than that used in other procedures, such as the Linton-type procedure. This incision allows the surgeon to access the subfascial space where the perforator veins are located.
Following the ligation procedure, patients are typically monitored for any immediate complications. Post-procedure care may include instructions for wound care, pain management, and activity restrictions to ensure proper healing. Patients are advised to keep the incision site clean and dry, and to follow up with their healthcare provider for any necessary evaluations. Recovery time may vary, but patients can generally expect to resume normal activities within a few weeks, depending on individual healing processes and the extent of the procedure performed.
| Short Descr | LIGATE LEG VEINS OPEN | Medium Descr | LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG | Long Descr | Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 53 - Varicose vein stripping, lower limb |
| LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | SG | Ambulatory surgical center (asc) facility service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2010-01-01 | Added | - |