How To Use CPT Code 36200

CPT 36200 describes the introduction of a catheter into the aorta for diagnostic studies of the cervicocerebral arteries. 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 36200?

CPT 36200 can be used to describe the introduction of a catheter into the aorta for diagnostic studies of the cervicocerebral arteries. This code is used when a healthcare provider inserts a catheter into a distal artery and then into the aorta to perform aortography or measure pressure inside the aorta.

2. Official Description

The official description of CPT code 36200 is: ‘Introduction of catheter, aorta.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia if necessary.
2. The provider punctures the site over a peripheral artery, typically the femoral artery, using a needle.
3. A guidewire is inserted through a sheath in the needle.
4. The provider inserts the catheter over the guidewire into the artery and guides it through the artery and into the aorta.
5. The provider confirms the placement of the catheter in the aorta.
6. Contrast material is injected, and the provider visualizes it through X-ray or fluoroscopic images.
7. If necessary, a pressure measuring device may be inserted to measure aortic pressure.

4. Qualifying circumstances

CPT 36200 is used for diagnostic studies of the cervicocerebral arteries. It is performed when non-selective angiography of the extracranial carotid and/or cerebral vessels and cervicocerebral arch is required. The code includes the work of accessing the vessel, placement of the catheter, contrast injection, fluoroscopy, radiological supervision and interpretation, and closure of the arteriotomy by pressure or application of an arterial closure device.

5. When to use CPT code 36200

CPT code 36200 should be used when a healthcare provider needs to perform diagnostic studies of the cervicocerebral arteries by introducing a catheter into the aorta. It is important to note that this code should not be reported if selective angiography of the extracranial carotid and/or cerebral vessels and cervicocerebral arch is performed. In such cases, CPT codes 36221-36228 should be used instead.

6. Documentation requirements

To support a claim for CPT 36200, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for diagnostic studies of the cervicocerebral arteries
• Details of the procedure, including the site of catheter insertion and the type of contrast material used
• Date and time of the procedure
• Confirmation of catheter placement in the aorta
• Images obtained during the procedure, such as X-ray or fluoroscopic images
• Any additional findings or observations made during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 36200, ensure that the procedure involves the introduction of a catheter into the aorta for diagnostic studies of the cervicocerebral arteries. It is important to note that this code should not be reported if selective angiography of the extracranial carotid and/or cerebral vessels and cervicocerebral arch is performed. In such cases, CPT codes 36221-36228 should be used instead.

8. Historical information

CPT 36200 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 introduces a catheter into the aorta for diagnostic studies of the cervicocerebral arteries in a patient with suspected carotid artery stenosis.
2. A patient with a history of stroke undergoes a procedure in which a catheter is inserted into the aorta for diagnostic studies of the cervicocerebral arteries to assess the blood flow in the carotid and vertebral arteries.
3. A healthcare provider performs aortography by introducing a catheter into the aorta to evaluate the presence of an aortic aneurysm in a patient.
4. A patient with suspected vascular malformation undergoes a procedure in which a catheter is inserted into the aorta for diagnostic studies of the cervicocerebral arteries to visualize the blood vessels in the head and neck.
5. A healthcare provider performs aortography to measure the pressure inside the aorta in a patient with suspected hypertension.
6. A patient with a history of transient ischemic attack undergoes a procedure in which a catheter is inserted into the aorta for diagnostic studies of the cervicocerebral arteries to assess the blood flow in the carotid and vertebral arteries.
7. A healthcare provider introduces a catheter into the aorta for diagnostic studies of the cervicocerebral arteries in a patient with suspected arteriovenous malformation.
8. A patient with suspected carotid artery dissection undergoes a procedure in which a catheter is inserted into the aorta for diagnostic studies of the cervicocerebral arteries to visualize the blood vessels in the head and neck.
9. A healthcare provider performs aortography to evaluate the presence of aortic coarctation in a patient with suspected congenital heart disease.