How To Use CPT Code 36140

CPT 36140 describes the introduction of a needle or intracatheter into an upper or lower extremity artery for injection 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 36140?

CPT 36140 can be used to report the introduction of a needle or intracatheter into an upper or lower extremity artery for injection purposes. This code is used when a physician makes a small incision in the skin and inserts the needle or intracatheter into the artery, guiding it to the area of focus. The procedure may be performed to introduce fluids or for pressure monitoring. An intracatheter is a plastic tube attached to a needle, which is removed once the catheter is in place. It is used to instill medications, fluids, and contrast material, and may also be used to monitor pressure in an artery.

2. Official Description

The official description of CPT code 36140 is: ‘Introduction of needle or intracatheter, upper or lower extremity artery.’

3. Procedure

1. The physician makes a small incision in the skin.
2. The needle or intracatheter is inserted into an upper or lower extremity artery.
3. The physician guides the needle or intracatheter to the area of focus.
4. If an intracatheter is used, the needle is removed once the catheter is in place.
5. The procedure may be performed to introduce fluids or for pressure monitoring.

4. Qualifying circumstances

CPT 36140 is used when a physician introduces a needle or intracatheter into an upper or lower extremity artery for injection purposes. It should not be reported in conjunction with codes 36836 and 36837. For the insertion of an arteriovenous cannula, refer to codes 36810-36821.

5. When to use CPT code 36140

CPT code 36140 should be used when a physician introduces a needle or intracatheter into an upper or lower extremity artery for injection purposes. It should not be used for selective catheterization or when codes for nonselective catheterization are applicable. It is important to code each vascular family separately and to code additional imaging studies performed.

6. Documentation requirements

To support a claim for CPT 36140, the physician must document the following information:

• Point(s) of access where the sheath has been placed
• Approach (ipsilateral or contralateral)
• Point(s) of the highest level where the catheter was manipulated
• Imaging studies performed

7. Billing guidelines

When billing for CPT 36140, ensure that the procedure involves the introduction of a needle or intracatheter into an upper or lower extremity artery. It should not be reported with codes 36836 and 36837. Selective catheterization supersedes codes for nonselective catheterization, and both should not be coded for the same access and in the same vascular family. Code each vascular family separately and include additional second or third order catheterizations and imaging studies above the basic examination.

8. Historical information

CPT 36140 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2018, to include the introduction of a needle or intracatheter into an extremity artery.

9. Examples

1. A physician introducing a needle into a patient’s upper extremity artery for the injection of contrast material.
2. A physician inserting an intracatheter into a patient’s lower extremity artery for the administration of medications.
3. A physician guiding a needle into a patient’s brachial artery for pressure monitoring.
4. A physician introducing an intracatheter into a patient’s femoral artery for the instillation of fluids.
5. A physician inserting a needle into a patient’s popliteal artery for the injection of contrast material.
6. A physician guiding a needle into a patient’s carotid artery for pressure monitoring.
7. A physician introducing an intracatheter into a patient’s vertebral artery for the administration of medications.
8. A physician inserting a needle into a patient’s other peripheral artery for the injection of contrast material.
9. A physician guiding a needle into a patient’s arteriovenous shunt created for dialysis.
10. A physician introducing an intracatheter into a patient’s arteriovenous shunt created for dialysis for the administration of medications.