How To Use CPT Code 36245

CPT 36245 describes the selective placement of a catheter in each first order 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 and billing examples.

1. What is CPT Code 36245?

CPT 36245 can be used to describe the selective placement of a catheter in each first order abdominal, pelvic, or lower extremity artery branch within a vascular family. This code is used when a physician inserts a catheter into the specific arteries of interest to visualize and diagnose medical conditions.

2. Official Description

The official description of CPT code 36245 is: ‘Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family.’

3. Procedure

1. The physician gains access to the blood vessels, typically through the femoral artery in the groin or arm.
2. A small incision is made in the skin, and a guide wire is inserted through a sheath.
3. A catheter is then guided through the arteries to the specific area of interest.
4. Contrast material is injected through the catheter, and X-ray or fluoroscopic images are taken to visualize the blood vessels.

4. Qualifying circumstances

CPT 36245 is used when a physician selectively places a catheter in each first order abdominal, pelvic, or lower extremity artery branch within a vascular family. It is important to note that this code supersedes codes for non-selective catheter placement, and only one code should be reported for each access and vascular family.

5. When to use CPT code 36245

CPT code 36245 should be used when a physician selectively places a catheter in each first order abdominal, pelvic, or lower extremity artery branch within a vascular family. It is important to ensure that the catheter placement is selective and not non-selective, as there are separate codes for each type of placement.

6. Documentation requirements

To support a claim for CPT 36245, the physician must document the following information:

• The specific arteries in which the catheter was placed
• The point(s) of access where the sheath was placed
• The approach used (ipsilateral or contralateral)
• The highest level where the catheter was manipulated
• Any additional imaging studies performed

7. Billing guidelines

When billing for CPT 36245, ensure that the catheter placement is selective and not non-selective. It is important to code for each vascular family separately and each access separately. Additional second or third order catheterizations within a family should also be coded separately. It is important to code all imaging studies performed in addition to the basic examination.

8. Historical information

CPT 36245 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 physician selectively placing a catheter in each first order abdominal artery branch to visualize and diagnose a patient’s abdominal condition.
2. A physician inserting a catheter into each first order pelvic artery branch to assess and treat a patient’s pelvic condition.
3. A physician guiding a catheter into each first order lower extremity artery branch to evaluate and manage a patient’s lower extremity vascular disease.
4. A physician selectively placing a catheter in each first order abdominal artery branch to perform an angioplasty and stent placement for a patient with arterial blockages.
5. A physician inserting a catheter into each first order pelvic artery branch to embolize abnormal blood vessels in a patient with pelvic bleeding.
6. A physician guiding a catheter into each first order lower extremity artery branch to administer thrombolytic therapy for a patient with acute arterial occlusion.
7. A physician selectively placing a catheter in each first order abdominal artery branch to perform a transcatheter arterial chemoembolization for a patient with liver cancer.
8. A physician inserting a catheter into each first order pelvic artery branch to perform uterine artery embolization for a patient with symptomatic fibroids.
9. A physician guiding a catheter into each first order lower extremity artery branch to perform endovascular revascularization for a patient with peripheral arterial disease.
10. A physician selectively placing a catheter in each first order abdominal artery branch to perform an arteriogram for a patient with suspected mesenteric ischemia.