CPT code 37244 – Transcatheter embolization for hemorrhage

Key takeaways

CPT code 37244 reports vascular embolization or occlusion for arterial or venous hemorrhage or lymphatic extravasation, with any embolizing agent.

The indication decides the code. Bleeding goes to 37244, tumors and organ ischemia to 37243, and other arterial targets to 37242.

A pseudoaneurysm without hemorrhage is reported with 37242, not 37244.

The operative report must document the bleeding source, vessel accessed, catheter position, embolizing agent, and pre- and post-embolization angiography.

Pabau, the practice management platform we build, attaches that documentation to each 37244 claim and submits it through Claim.MD, our US clearinghouse partner.

CPT code 37244: Official descriptor and clinical scope

CPT code 37244 reports vascular embolization or occlusion performed to control arterial or venous hemorrhage or lymphatic extravasation. The American Medical Association descriptor has two parts, separated by a semicolon. The stem shared by 37241-37244 reads:

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention;

The part specific to 37244 then reads: For arterial or venous hemorrhage or lymphatic extravasation.

Two elements define when 37244 applies. The first is the vessel: Arterial or venous, anywhere outside the head, neck and central nervous system. The second is the indication: Active bleeding from an artery or vein, or a lymphatic leak such as a thoracic duct injury. Embolization in the central nervous system is reported with 61624 instead, and non-CNS head or neck work with 61626.

Neither the vessel type nor the embolizing agent restricts the code. The clinical purpose does. A coder who picks the code from the vessel embolized, rather than the reason for embolizing it, will produce incorrect claims consistently.

Descriptor element breakdown

How 37244 fits the 37241-37244 embolization family

The four codes in this family share a procedure type but split by clinical indication. Coders who sort them by indication rather than anatomy resolve operative reports faster.

Uterine fibroid embolization is a common point of confusion. UFE for fibroid symptoms is reported with 37243, because the target is a tumor. 37244 applies only when the embolization is done to control active hemorrhage, and the operative note must say so.

The decision path below runs the four questions in the order that settles the code fastest.

37244 vs 37242: Choosing the correct embolization code

37244 differs from 37242 in one critical way: The clinical purpose is bleeding or a lymphatic leak. Both may involve arterial access, but that is where the similarity ends.

The 37243 question works the same way. 37243 applies when the target is a tumor, organ ischemia or infarction. If the same vessel and technique stop bleeding from a tumor rather than destroying it, 37244 applies. Hemostasis is then the primary intent.

Procedures reported under CPT code 37244

The following scenarios are correctly reported with CPT code 37244 when the operative documentation confirms hemostasis or a lymphatic leak as the clinical goal.

• Gastrointestinal hemorrhage embolization: Superior mesenteric artery branch embolization for a diverticular bleed or post-polypectomy bleeding. Paired ICD-10: K92.1 (melena), K57.31 (diverticulosis of large intestine without perforation or abscess with bleeding).
• Postpartum hemorrhage: Uterine artery embolization performed emergently for uncontrolled bleeding after delivery. Paired ICD-10: O72.1 (other immediate postpartum hemorrhage).
• Trauma-related hemorrhage: Splenic, hepatic, or pelvic arterial embolization following blunt or penetrating trauma. Paired ICD-10: S36.x (injury of intra-abdominal organs), S37.x (injury of pelvic organs).
• Bronchial artery embolization for hemoptysis: Bronchial artery or systemic collateral embolization when the indication is life-threatening or significant hemoptysis. Paired ICD-10: R04.2 (hemoptysis).
• Bleeding pseudoaneurysm embolization: A visceral or peripheral pseudoaneurysm occluded after rupture or active bleeding. Pair I72.x only when rupture or hemorrhage is documented, and report an unruptured pseudoaneurysm with 37242.
• Thoracic duct embolization: Glue, coils or a plug placed to seal a thoracic duct leak, which the descriptor covers as lymphatic extravasation.
• Post-procedural hemorrhage: Embolization to control bleeding at a surgical site or organ following a prior intervention.

Prostate artery embolization for BPH is reported with 37243, because the indication is organ ischemia. 37244 does not apply to PAE, since bleeding is not the reason for the procedure.

Companion codes commonly billed with CPT 37244

CPT 37244 is a primary procedure code, and some services in the same session may be reported separately when properly documented. Selective catheterization such as 36247 is the most common example. Superbill documentation for embolization encounters should capture each companion code with its supporting catheter placement notes.

Bundling caution: 37244 already includes radiological supervision and interpretation, intraprocedural roadmapping and imaging guidance. Angiography is separately reportable only as a distinct diagnostic study, when no prior imaging is available, and never for guidance. The NCCI edit tables, updated quarterly by CMS, define which catheterization and imaging codes are bundled. Check the current CMS NCCI edit tables before submitting companion codes.

CPT code 37244 reimbursement: Medicare fee schedule rates

CPT code 37244 is reimbursed under the Medicare Physician Fee Schedule. Rates are set annually and vary by geographic practice cost index (GPCI). The CMS Physician Fee Schedule Look-Up Tool is the primary source for current rates. Always verify there before quoting a reimbursement amount to a practice.

37244 carries a higher work RVU than 37241 or 37242, because hemorrhage procedures typically involve greater clinical complexity and urgency. Hospital-based IR procedures like this one are generally facility-priced. The non-facility value may even be listed as not applicable. Check facility and non-facility values in the CMS look-up before quoting either. Commercial payers negotiate rates above Medicare in most markets.

For current dollar rates, use the FastRVU 2026 RVU lookup or the CMS Look-Up Tool directly. Dollar figures change every January with the annual conversion factor update. Never rely on figures quoted in secondary sources without confirming the effective year.

Prior authorization and payer coverage requirements

Prior authorization requirements for CPT code 37244 vary by payer and plan type. Emergency hemorrhage control is generally not subject to prior auth, because clinical urgency makes pre-approval impractical. Scheduled cases, such as a planned embolization after a prior bleed, frequently need pre-approval from commercial payers.

Documentation to support a prior authorization request or a retrospective review typically includes:

• Imaging evidence confirming active hemorrhage or a lymphatic leak (angiography, CT angiogram, or other cross-sectional imaging)
• Clinical notes documenting the indication, its severity, and why endovascular management was chosen over surgical or conservative alternatives
• Supporting ICD-10-CM diagnosis codes that directly reflect the hemorrhage indication (see next section)
• Payer-specific medical necessity criteria. Medicare follows Local Coverage Determinations where applicable, and commercial payers reference internal policies that should be checked individually.

Horizon Blue Cross Blue Shield, a large commercial payer with published vascular coding policy, specifies documentation of clinical urgency and imaging confirmation for embolization procedures. Never assume a payer does or does not require prior auth. Check the current payer policy document or portal for each case.

ICD-10-CM diagnosis codes to pair with CPT 37244

The ICD-10-CM diagnosis code must directly support the hemorrhage or lymphatic leak. Pairing 37244 with a diagnosis that does not reflect active bleeding is one of the most common medical necessity denial triggers.

Verify each ICD-10-CM code against the CDC/NCHS ICD-10-CM web tool for the current fiscal year. Codes are updated each October, so a code valid in FY 2025 may be retired or revised in FY 2026.

Common denial reasons for CPT code 37244 and how to appeal

37244 claims are denied most often for five reasons. Each has a specific documentation fix and an appeal strategy.

• Wrong code (37242 billed instead of 37244): The operative report contained hemorrhage language, but the coder defaulted to 37242. Fix: Resubmit with 37244 and attach the operative report section stating the hemorrhage indication. Reference the AMA descriptor distinction in the appeal letter.
• Hemorrhage indication absent from operative report: The diagnosis code listed bleeding, but the procedure note did not state it explicitly. Fix: Obtain a physician addendum documenting that hemostasis was the clinical intent. Do not alter the original report, because dated and attested addenda are acceptable.
• Unbundled catheterization codes: 36247 or 36246 billed separately when NCCI edits bundle them into 37244 for that service date. Fix: Review the current NCCI edit table, retract the unbundled code, and resubmit. For denial management workflows at scale, track these edit patterns across payers to catch systematic coding errors before submission.
• Missing or expired prior authorization: A commercial payer required prior auth, and the claim went out without it. Fix: Contact the payer’s provider relations line and document any emergency exception policy. If the procedure was unscheduled, appeal with clinical urgency documentation. Clean claim checks at intake flag auth requirements before the procedure date.
• Mismatched ICD-10 codes: The diagnosis code does not reflect active hemorrhage, triggering a medical necessity denial. Fix: Correct the ICD-10-CM code to reflect the bleeding indication and resubmit with supporting clinical documentation. Reference the procedure note language in the appeal.

Tracking denial codes by code and payer shows whether a 37244 denial pattern is systemic or isolated. A systemic pattern points to the coding workflow and warrants an education session with the IR team. A one-off denial usually traces to a single encounter’s documentation and warrants a targeted appeal.

Documentation checklist for CPT code 37244 claims

A 37244 claim is most likely to pay on first submission when the operative report contains all of the following elements. Use this as a pre-billing review checklist.

• Indication stated explicitly: The indication section of the operative note must name the bleeding source or lymphatic leak and confirm hemostasis as the procedural goal.
• Vascular access documented: Entry site (femoral, radial, brachial), approach (percutaneous), and the initial vessel catheterized.
• Catheter position confirmed by imaging: Post-placement fluoroscopy or angiography confirming the catheter tip position before embolization.
• Embolizing agent named and quantity documented: Specify the agent (coils, Gelfoam slurry, microspheres, NBCA glue) and quantity used. Vague language like “appropriate embolization was performed” is insufficient.
• Pre-embolization angiogram documented: Imaging demonstrating active extravasation or the bleeding source before treatment.
• Post-embolization angiogram documented: Imaging confirming successful hemostasis following embolization.
• Vessels treated named specifically: Include the vessel name, order of catheterization (1st, 2nd, 3rd order), and vascular territory.
• Physician attestation: Attending or performing physician signature and date of service confirmation.

How claims management software cuts 37244 denials

In many IR practices, the coder reads the operative report in one system and keys the claim into another. The hemorrhage indication can get lost between the two, and the denial only surfaces weeks later.

Pabau’s claims management software lets practices attach procedure documentation to each claim record before submission. Billing staff can work through the checklist above while the claim is built, rather than during a denial appeal.

Claims go out through Claim.MD, our US clearinghouse partner, as electronic CMS-1500 claims to thousands of US payers. Eligibility is checked in real time before submission. Claim statuses and ERA remittances then flow back into Pabau, so each 37244 claim can be followed to payment or denial.

Manage CPT 37244 claims with less manual work

Pabau keeps the operative note attached to each 37244 claim, checks eligibility in real time, and submits CMS-1500 claims through Claim.MD. See how it works for interventional radiology and vascular surgery practices.

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Conclusion

Code 37244 when the operative note shows the vessel was closed to stop arterial or venous hemorrhage or a lymphatic leak. A pseudoaneurysm without hemorrhage goes to 37242, and a fibroid or tumor goes to 37243.

The cheapest fix sits upstream of billing. When the IR team names the bleeding source and hemostatic intent in the indication line, wrong-code and medical necessity denials have little to catch on. The trade-off is a few extra words per note against weeks of appeal work.

If your billers still chase operative notes after a denial, book a demo to see how Pabau keeps the documentation attached to every 37244 claim.

Continue your research

Need a clearinghouse for electronic claims submission? Medical claims clearinghouse guide covers how clearinghouses validate, route, and track claims before they reach payers.

Want to understand how remittance works after a claim pays? Electronic remittance advice explained covers ERA formats, 835 transaction sets, and how to match payments to claims.

Dealing with recurring claim rejections? Revenue cycle management overview maps the billing workflow from charge capture through payment posting.

Coding a venous embolization instead? CPT code 37241 covers venous embolization for varicoceles, varices and venous malformations.

Billing a diagnostic angiogram alongside embolization? CPT code 75710 explains when extremity angiography is reported as a distinct study.

Frequently asked questions