CPT® Code 75978 | Case2Code

Code deleted. See 36902, 36905, 36907, 37248, 37249.

Official Description

Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation

Common Language Description

The CPT® Code 75978 refers to the procedure of transluminal balloon angioplasty performed on a vein, specifically for conditions such as subclavian stenosis. This procedure involves the use of a balloon catheter to open up narrowed or obstructed veins, thereby improving blood flow. The term "transluminal" indicates that the procedure is performed within the lumen of the vein. During this intervention, radiological supervision and interpretation are crucial, as they guide the physician in navigating the anatomy and ensuring the correct placement of the catheter and balloon. The process begins with the preparation of the skin over the access vein, followed by puncturing the vein with a needle to insert a sheath. A guidewire is then introduced, allowing for the advancement of a catheter equipped with a balloon tip to the site of the occlusion. Once in position, the balloon is inflated to compress any plaque against the vessel wall, which may require multiple inflations to achieve optimal results. After the angioplasty, a venography catheter is used to perform a completion venogram, confirming that the vein is patent. The procedure concludes with the application of pressure to the puncture site to control bleeding, and a dressing is applied. The radiological supervision and interpretation involved in this procedure are reported separately under the same code, ensuring comprehensive documentation and billing for the services rendered.

1. Indications

The procedure associated with CPT® Code 75978 is indicated for various conditions that result in venous stenosis or occlusion. These indications may include:

Subclavian Stenosis This condition involves narrowing of the subclavian vein, which can lead to compromised blood flow and associated symptoms.
Venous Occlusion This refers to a blockage in the vein that can impede normal blood circulation, potentially causing swelling, pain, or other complications.
Chronic Venous Insufficiency This condition occurs when veins cannot pump enough blood back to the heart, often leading to varicose veins and other venous disorders.

2. Procedure

The procedure for CPT® Code 75978 involves several critical steps to ensure successful transluminal balloon angioplasty. Each step is essential for achieving the desired outcome of restoring venous patency.

Step 1: Preparation The skin over the access vein is thoroughly prepped to maintain a sterile environment. This is a crucial step to prevent infection during the procedure.
Step 2: Venous Access A needle is used to puncture the vein, allowing for the insertion of a sheath. This sheath serves as a conduit for the subsequent instruments used in the procedure.
Step 3: Guidewire Insertion A guidewire is carefully inserted through the sheath and advanced into the occluded vein. This guidewire is essential for navigating the anatomy and facilitating the placement of the balloon catheter.
Step 4: Catheter Advancement A catheter with a balloon tip is advanced over the guidewire to the site of the occlusion. This step is critical as it positions the balloon at the precise location where intervention is needed.
Step 5: Balloon Inflation The balloon is inflated to compress the plaque against the vessel wall. This inflation may be repeated several times to achieve optimal dilation of the vein.
Step 6: Guidewire Exchange After the angioplasty, the angioplasty catheter is exchanged for a guidewire, which is necessary for the next step of the procedure.
Step 7: Venography A venography catheter is advanced over the guidewire, and the guidewire is then withdrawn. Contrast material is injected to visualize the vein, and a completion venogram is performed to confirm that the vein is patent.
Step 8: Closure The venography catheter is withdrawn, and pressure is applied over the puncture site to control any bleeding. A pressure dressing is applied, or if an open repair is performed, the access vein is repaired, and the skin incision is closed.

3. Post-Procedure

Post-procedure care for CPT® Code 75978 includes monitoring the puncture site for any signs of bleeding or complications. Patients may be advised to rest and avoid strenuous activities for a specified period to promote healing. Follow-up imaging may be required to ensure the success of the angioplasty and to assess the patency of the vein. Additionally, healthcare providers may provide instructions regarding pain management and signs of potential complications that should prompt immediate medical attention.

Short Descr	REPAIR VENOUS BLOCKAGE
Medium Descr	TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I
Long Descr	Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	9 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - 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	T-Packaged Codes
Type of Service (TOS)	6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS)	I1F - Standard imaging - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	191 - Arterio- or venogram (not heart and head)