Documenting Occlusions for 2026 Lower Extremity Endovascular Revascularization Coding

Question:

The CPT guidelines for the lower extremity endovascular revascularization codes state that a straightforward lesion is a stenosis and a complex lesion is an occlusion. When documenting treatment of an occlusion, must the operative report specify the degree of blockage (for example, 100% or total), or does documentation of the lesion as an occlusion alone support reporting a complex lesion?

Answer:

Documentation of the lesion as an occlusion alone is sufficient to support reporting treatment of a complex lesion. CPT defines lesion complexity by lesion type, not by a percentage of narrowing, and an occlusion by definition represents complete blockage. CPT does not require documentation of “100%” or “total” for code selection. That said, because these codes are newly implemented, providers and coders should continue to monitor local MAC and commercial payer policies for any additional documentation requirements as payers begin to adjudicate claims.

*This response is based on the best information available as of 01/08/26.