How To Use CPT Code 36100

CPT 36100 describes the introduction of a needle or intracatheter into the carotid or vertebral artery for diagnostic or treatment purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36100?

CPT 36100 can be used to describe the introduction of a needle or intracatheter into the carotid or vertebral artery. This procedure is performed by a healthcare provider to diagnose or treat various disorders. It is important to note that for a bilateral procedure, modifier 50 should be added to the code.

2. Official Description

The official description of CPT code 36100 is: ‘Introduction of needle or intracatheter, carotid or vertebral artery (For bilateral procedure, report 36100 with modifier 50)’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. A guide wire is inserted through a sheath into the carotid or vertebral artery.
3. A catheter is then advanced into the artery to reach the targeted site.
4. Contrast material is injected through the catheter to visualize the blood vessels using fluoroscopy or X-rays.

4. Qualifying circumstances

CPT 36100 is performed when a healthcare provider needs to access the carotid or vertebral artery to diagnose or treat certain conditions. It is important to note that this procedure should only be performed by a qualified healthcare provider. The use of a needle or intracatheter is necessary to reach the targeted site within the artery.

5. When to use CPT code 36100

CPT code 36100 should be used when a healthcare provider performs the procedure of introducing a needle or intracatheter into the carotid or vertebral artery. It is important to ensure that the procedure is performed for diagnostic or treatment purposes and that the appropriate documentation is provided.

6. Documentation requirements

To support a claim for CPT 36100, the healthcare provider must document the following information:

• Reason for performing the procedure and the specific condition being diagnosed or treated
• Details of the procedure, including the approach and points of access
• Date and time of the procedure
• Use of contrast material and any imaging studies performed
• Any additional procedures or interventions performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 36100, ensure that the procedure is performed by a qualified healthcare provider and that the appropriate documentation is provided. If the procedure is performed bilaterally, modifier 50 should be added to the code. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 36100 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider introducing a needle into the carotid artery to perform a diagnostic angiogram.
2. A physician inserting an intracatheter into the vertebral artery to administer thrombolytic therapy for a stroke patient.
3. A radiologist guiding a needle into the carotid artery to perform an embolization procedure for a patient with a vascular malformation.
4. An interventional cardiologist introducing an intracatheter into the carotid artery to perform a coronary angiogram.
5. A vascular surgeon inserting a needle into the vertebral artery to perform a diagnostic angiogram for a patient with suspected vertebral artery stenosis.
6. A neurosurgeon guiding a needle into the carotid artery to perform an endovascular coiling procedure for a patient with a cerebral aneurysm.
7. An interventional radiologist introducing an intracatheter into the vertebral artery to perform a vertebroplasty procedure for a patient with a vertebral compression fracture.
8. A vascular surgeon inserting a needle into the carotid artery to perform a carotid endarterectomy for a patient with carotid artery stenosis.
9. An interventional neuroradiologist guiding a needle into the vertebral artery to perform an intra-arterial thrombectomy for a patient with an acute ischemic stroke.
10. A cardiovascular surgeon introducing an intracatheter into the carotid artery to perform a carotid artery stenting procedure for a patient with carotid artery disease.