How To Use CPT Code 36246

CPT 36246 describes the selective placement of a catheter in a second order abdominal, pelvic, or lower extremity artery branch within a vascular family. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36246?

CPT 36246 can be used to describe the selective placement of a catheter in a second 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 artery branch to perform angiography, an X-ray study of the blood vessels.

2. Official Description

The official description of CPT code 36246 is: ‘Selective catheter placement, arterial system; initial second 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 second order artery branch within the vascular family.
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 36246 is used when a physician performs selective catheter placement in a second 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 both selective and non-selective catheter placement should not be coded together in the same access and vascular family.

5. When to use CPT code 36246

CPT code 36246 should be used when a physician performs the selective placement of a catheter in a second order abdominal, pelvic, or lower extremity artery branch within a vascular family. It is important to accurately document the specific artery branch and the vascular family to support the use of this code.

6. Documentation requirements

To support a claim for CPT 36246, the physician must document the following information:

• Point(s) of access where the sheath has been placed (e.g., femoral, radial, jugular, brachial)
• Approach used (ipsilateral or contralateral)
• Point(s) of the highest level where the catheter was manipulated
• Imaging studies performed
• Each vascular family and access coded separately
• Additional second or third order catheterizations within a family
• Additional imaging studies within a family above the basic examination

7. Billing guidelines

When billing for CPT 36246, ensure that the procedure meets the criteria for selective catheter placement in a second order abdominal, pelvic, or lower extremity artery branch within a vascular family. It is important to code each vascular family and access separately. Do not report both selective and non-selective catheter placement in the same access and vascular family. Additionally, code all imaging studies performed during the procedure.

8. Historical information

CPT 36246 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Examples

1. A physician performs selective catheter placement in the second order abdominal artery branch of a patient to visualize the blood vessels in that area.
2. During an angiography procedure, a physician inserts a catheter into the second order pelvic artery branch to diagnose and treat a medical condition.
3. A patient undergoes a catheter placement in the second order lower extremity artery branch to assess the blood flow in that specific area.
4. A physician performs selective catheter placement in the second order abdominal artery branch of a patient to guide a treatment intervention.
5. During an angiography procedure, a physician inserts a catheter into the second order pelvic artery branch to embolize a blood vessel.
6. A patient undergoes a catheter placement in the second order lower extremity artery branch to administer medication directly to that area.
7. A physician performs selective catheter placement in the second order abdominal artery branch of a patient to evaluate the effectiveness of a previous treatment.
8. During an angiography procedure, a physician inserts a catheter into the second order pelvic artery branch to identify any blockages or abnormalities.
9. A patient undergoes a catheter placement in the second order lower extremity artery branch to assist in the placement of a stent.
10. A physician performs selective catheter placement in the second order abdominal artery branch of a patient to assess the blood flow to a specific organ.