![]() ![]() The physician advances the catheter into the celiac artery for injection and imaging, followed by catheterization of the superior mesenteric artery and inferior mesenteric artery for injection and imaging.Ĭatheterization Codes: 36245, 36245-59, 36245-59Įxplanation: This example demonstrates selective catheterization of multiple vascular families. If more than one vascular family is catheterized, each vascular family is reported separately.Įxample: Access is gained at the right common femoral artery. Additionally, once the catheter is advanced into the left hepatic artery, a third order vessel (36247), the 36246 is no longer assigned because it is bundled into 36247.Ĭode each vascular family separately. The celiac is a first order vessel (36245), however once the catheter is advanced into the common hepatic, a second order vessel (36246), the 36245 is no longer assigned because it is bundled into 36246. Once the catheter is advanced through the aorta into another vessel, the non‐selective catheterization (36200) is bundled into the selective catheterization code. The physician advances the catheter to the aorta (non-selective), injects contrast and provides an interpretation for an abdominal aortogram, then advances the catheter into celiac artery (selective) for injection and imaging, followed by injection and imaging of both the common hepatic and the left hepatic arteries.Įxplanation: The catheterization of the aorta (36200) is non‐selective and the catheterization of the celiac artery (36245) is selective. A third order catheterization is coded over a second order catheterization, and a second order catheterization is coded over a first order catheterization.Įxample: Access is gained at the right common femoral artery. Catheterization codes are assigned based on the furthest catheter placements achieved within a vascular family. Once the catheter is advanced through the aorta into another vessel, the non‐selective catheterization (36200) is bundled into the selective catheterization (36215) and only the code for selective catheterization is assigned.Ĭode to the highest order selectivity. The physician advances the catheter to the aorta (non-selective), injects contrast and provides an interpretation for an abdominal aortogram, the catheter is placed into the left subclavian artery (selective) for injection and imaging.Įxplanation: The catheterization of the aorta (36200) is non‐selective and the catheterization of the left subclavian artery (36215) is selective. Non-selective catheterization is bundled with selective catheterization.Įxample: Access is gained at the right common femoral artery. When both a non-selective catheterization and a selective catheterization are performed through the same point of access, only the code for the selective catheterization is assigned. Selective catheterizations are classified as either first, second or third order and beyond.ĬPT codes 36215 (first order), 36216 (second order), 36217 (third order), +36218 (additional second, third or beyond) are selective catheterization codes assigned when performed above the diaphragm.ĬPT codes 36245 (first order), 36246 (second order), 36247 (third order) +36248 (additional second, third or beyond) are selective catheterization codes assigned when performed below the diaphragm.Īlways code selective over non‐selective catheterization. Selective catheter placement indicates that the catheter is advanced through the vessel punctured beyond the aorta into a vascular family, or in the case of an ipsilateral antegrade procedure, the catheter is advanced into a network of vessels that arise from the access site. Nonselective catheter placement indicates the catheter is placed directly into an artery and the catheter is not advanced further into a branch vessel or is advanced only into the aorta from any approach.ĬPT codes 36140, 36200, 36160, 36100 are examples of non-selective catheterization codes. When coding interventional radiology procedures, catheterization codes are classified as non-selective or selective. To achieve success with interventional radiology coding, one of the first areas a coder must master is deciphering catherization coding rules to correctly assign non-selective and selective catheterization codes. There are many reasons why interventional radiology coding is so very challenging, but one of the main reasons is that many codes may be required to accurately capture all of the steps of a vascular procedure. It is widely acknowledged that interventional radiology is one of the most complex medical coding specialties to master.
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