How To Use CPT Code 36247

CPT 36247 is a code used for selective catheter placement in the arterial system, specifically for the initial third order or more selective abdominal, pelvic, or lower extremity artery branch within a vascular family. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 36247 procedures.

1. What is CPT 36247?

CPT 36247 is a code used in the Current Procedural Terminology (CPT) system to describe a specific type of selective catheter placement in the arterial system. This code is specifically for the initial third order or more selective abdominal, pelvic, or lower extremity artery branch within a vascular family. Medical professionals use this code to bill for angiography procedures that involve the selective placement of a catheter in these specific arteries.

2. 36247 CPT code description

The official description of CPT code 36247 is: “Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family.”

3. Procedure

The 36247 procedure involves the following steps:

1. The patient is prepared for the angiography procedure, and the area of the groin or arm where the catheter is to be inserted is cleaned with antiseptic liquid.
2. Under local anesthesia, the physician makes a small incision in the skin.
3. A guide wire is placed through a sheath, followed by the insertion of a catheter into an artery.
4. The catheter is guided through the arteries to the area of focus, which is the initial third order or more selective abdominal, pelvic, or lower extremity artery branch within a vascular family.
5. Contrast material is injected through the catheter, and blood vessels are visualized through several sets of X-ray and/or fluoroscopic images.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 36247 services are those who require angiography for the diagnosis or treatment of medical conditions related to the arterial system. This may include patients with peripheral arterial disease, aneurysms, arterial blockages, or other vascular abnormalities. The decision to perform this procedure and use CPT code 36247 for billing purposes is based on the physician’s assessment of the patient’s medical condition and the necessity of the procedure for diagnosis or treatment.

5. When to use CPT code 36247

It is appropriate to bill the 36247 CPT code when a physician performs a selective catheter placement in the initial third order or more selective abdominal, pelvic, or lower extremity artery branch within a vascular family. This code should be used for angiography procedures that involve the selective placement of a catheter in these specific arteries for the purpose of diagnosing or treating medical conditions related to the arterial system.

6. Documentation requirements

To support a claim for CPT 36247, the following information needs to be documented:

• Patient’s medical history and the reason for the angiography procedure
• Details of the procedure, including the specific artery branch where the catheter was placed and the use of contrast material
• Findings from the angiography, such as the presence of arterial blockages or other vascular abnormalities
• Any interventions performed during the procedure, if applicable
• Post-procedure care and follow-up recommendations

7. Billing guidelines

When billing for CPT code 36247, it is important to follow these guidelines:

• Ensure that the procedure is medically necessary and supported by the patient’s medical history and the physician’s assessment
• Document all relevant information related to the procedure, as outlined in the documentation requirements section
• Code for each vascular family and access separately
• Code additional second or third order catheterizations within a family, if applicable
• Code for additional imaging studies within a family above the basic examination, if applicable

8. Historical information

CPT 36247 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Similar codes to CPT 36247

Five similar codes to CPT 36247 and how they differentiate from CPT 36247 are:

• CPT 36245: This code is for the initial second order abdominal, pelvic, or lower extremity artery branch within a vascular family, rather than the third order or more selective branch.
• CPT 36246: This code is for the initial third order abdominal, pelvic, or lower extremity artery branch within a vascular family, but without the requirement of being more selective.
• CPT 36248: This code is for each additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch within a vascular family, after the initial third order or more selective branch.
• CPT 36215: This code is for the initial second order thoracic or brachiocephalic branch within a vascular family, rather than the abdominal, pelvic, or lower extremity artery branch.
• CPT 36216: This code is for the initial third order or more selective thoracic or brachiocephalic branch within a vascular family, rather than the abdominal, pelvic, or lower extremity artery branch.

10. Examples

Here are 10 detailed examples of CPT code 36247 procedures:

1. A patient with peripheral arterial disease undergoes angiography to assess the extent of arterial blockages in the lower extremities. The physician places a catheter in the initial third order or more selective branch of the patient’s femoral artery.
2. A patient with a suspected abdominal aortic aneurysm undergoes angiography for diagnostic purposes. The physician places a catheter in the initial third order or more selective branch of the patient’s abdominal aorta.
3. A patient with a history of pelvic pain undergoes angiography to evaluate the possibility of arterial abnormalities. The physician places a catheter in the initial third order or more selective branch of the patient’s internal iliac artery.
4. A patient with a known arterial blockage in the lower extremity undergoes angiography for treatment planning. The physician places a catheter in the initial third order or more selective branch of the patient’s popliteal artery.
5. A patient with a suspected renal artery stenosis undergoes angiography for diagnostic purposes. The physician places a catheter in the initial third order or more selective branch of the patient’s renal artery.
6. A patient with a history of intermittent claudication undergoes angiography to assess the extent of arterial blockages in the lower extremities. The physician places a catheter in the initial third order or more selective branch of the patient’s tibial artery.
7. A patient with a known iliac artery aneurysm undergoes angiography for treatment planning. The physician places a catheter in the initial third order or more selective branch of the patient’s external iliac artery.
8. A patient with a suspected mesenteric artery stenosis undergoes angiography for diagnostic purposes. The physician places a catheter in the initial third order or more selective branch of the patient’s superior mesenteric artery.
9. A patient with a history of deep vein thrombosis undergoes angiography to evaluate the possibility of arterial abnormalities in the lower extremities. The physician places a catheter in the initial third order or more selective branch of the patient’s peroneal artery.
10. A patient with a known arterial blockage in the pelvis undergoes angiography for treatment planning. The physician places a catheter in the initial third order or more selective branch of the patient’s internal pudendal artery.