How To Use CPT Code 36225

CPT 36225 describes the selective catheter placement procedure, which involves the insertion of a catheter into the subclavian or innominate artery, along with angiography of the ipsilateral vertebral circulation. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36225?

CPT 36225 is a code used to describe the selective catheter placement procedure. This procedure involves the insertion of a catheter into either the subclavian or innominate artery, followed by angiography of the ipsilateral vertebral circulation. The purpose of this procedure is to detect any vascular disease or abnormalities in the subclavian or innominate arteries and the ipsilateral vertebral circulation.

2. Official Description

The official description of CPT code 36225 is: ‘Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed.’

3. Procedure

1. In this procedure, the healthcare provider begins by preparing and anesthetizing the patient.
2. Using a needle, the provider punctures the site over a peripheral artery, typically the femoral artery.
3. A guidewire is then inserted through the needle and into the artery.
4. The needle is removed, and the provider threads the wire into the thoracic aorta and then into the branch of the aortic arch.
5. A catheter is then inserted into the vertebral artery.
6. The guidewire is removed, and contrast material is injected into the artery.
7. The provider performs angiography by taking several X-ray images of the subclavian or innominate arteries and the ipsilateral vertebral circulation.
8. After the imaging is complete, the catheter is removed, and pressure is applied to stop any bleeding from the incision site.

4. Qualifying circumstances

CPT 36225 is typically performed on patients who require angiography of the subclavian or innominate arteries and the ipsilateral vertebral circulation. This procedure is used to detect any vascular disease or abnormalities in these areas. It is important to note that this procedure is unilateral, meaning it is performed on one side of the body.

5. When to use CPT code 36225

CPT code 36225 should be used when a healthcare provider performs the selective catheter placement procedure, inserting a catheter into either the subclavian or innominate artery, and performs angiography of the ipsilateral vertebral circulation. This code should be used for unilateral procedures only.

6. Documentation requirements

To support a claim for CPT 36225, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for selective catheter placement and angiography
• Specific details of the procedure, including the site of catheter placement and the use of contrast material
• Date and duration of the procedure
• Images obtained during angiography
• Any complications or adverse reactions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 36225, ensure that the procedure meets the criteria for selective catheter placement and angiography as described in the official description. It is important to note that this code should not be reported with other codes for similar procedures. Additionally, be aware of any specific billing guidelines provided by insurance companies or payers.

8. Historical information

CPT 36225 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs selective catheter placement and angiography of the subclavian artery and ipsilateral vertebral circulation to detect any vascular abnormalities in a patient with suspected subclavian artery stenosis.
2. During a diagnostic workup for a patient with suspected vertebral artery occlusion, a healthcare provider performs selective catheter placement and angiography of the innominate artery and ipsilateral vertebral circulation.
3. A patient with a history of cerebrovascular disease undergoes selective catheter placement and angiography of the subclavian artery and ipsilateral vertebral circulation to assess the patency of the vessels and detect any potential blockages.
4. As part of a preoperative evaluation for a patient scheduled for carotid endarterectomy, a healthcare provider performs selective catheter placement and angiography of the innominate artery and ipsilateral vertebral circulation to assess the collateral circulation.
5. A patient with recurrent episodes of dizziness and vertigo undergoes selective catheter placement and angiography of the subclavian artery and ipsilateral vertebral circulation to evaluate the blood flow to the brain.