Does 37183 require prior authorization?

No, 37183 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 37183?

Medicare facility rate: $321.98. Non-facility rate: $5404.27. Work RVU: 7.55.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

7.55

Facility

$321.98

Non-Facility

$5404.27

Claims must be submitted with an ICD-10-CM code that represents the reason for the procedure, billed to the highest level of specificity and linked to the appropriate procedure code.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and include the legible signature of the responsible physician or non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Medical record documentation should list the type and length of conservative treatment attempted, as applicable per LCD L37893.

Endovenous stenting is covered when performed to treat severely symptomatic venous obstructions in accordance with LCD L37893.
Endovenous stenting is covered when used to treat severely symptomatic venous obstructions in accordance with LCD L38231.
Placement of an endovenous stent as an adjunct to a suboptimal or failed percutaneous transluminal angioplasty (PTA) when residual stenosis is >30% measured at the narrowest point of the lumen or when there is >50% reduction of luminal diameter.
Placement of an endovenous stent for angioplasty-related complications including an intimal tear with hemorrhage, abrupt persistent occlusion, dissection at the angioplasty site, occlusion from elastic recoil, or refractory spasm.
Primary endovenous stenting when angioplasty alone is not expected to provide a durable result (i.e., planned primary stent placement rather than post-angioplasty rescue).
Endovenous stenting for iliac vein compression syndrome (May-Thurner/Cockett syndrome) causing severe symptoms or obstruction.

A56644 — Billing and Coding: Endovenous Stenting

J09

L38231 — Endovenous Stenting

J09

A56414 — Billing and Coding: Endovenous Stenting

J12

L37893 — Endovenous Stenting

J12

AETNA-CPB-0259 — Transjugular Intrahepatic Portosystemic Shunt (TIPSS)

Ask Verity about documentation requirements, denial risks, or coverage in your state.