How To Use CPT Code 36248

CPT 36248 describes the selective placement of an additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch within a vascular family. 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 36248?

CPT 36248 is used to describe the selective placement of an additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch within a vascular family. This code is used when a physician performs a catheterization procedure to access specific arteries and guide the catheter to the desired area of focus. The procedure involves the use of contrast material to visualize the blood vessels under X-ray or fluoroscopic images.

2. Official Description

The official description of CPT code 36248 is: ‘Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate).’ This code should be used in conjunction with codes 36246 and 36247, and should not be reported with codes 36245, 36246, 36247, or 36836.

3. Procedure

1. The physician identifies the point of access, such as the femoral, radial, jugular, or brachial artery.
2. A small incision is made in the skin at the chosen access point, and the area is cleaned with antiseptic liquid.
3. A guide wire is inserted through a sheath into the artery.
4. A catheter is then threaded over the guide wire and guided through the arteries to the desired area of focus.
5. Contrast material is injected through the catheter to visualize the blood vessels under X-ray or fluoroscopic images.
6. The physician manipulates the catheter to selectively place it in the additional second order, third order, or beyond artery branch within the vascular family.
7. Multiple sets of X-ray or fluoroscopic images are taken to ensure proper placement and visualization of the blood vessels.

4. Qualifying circumstances

CPT 36248 is performed on patients who require selective catheter placement in an additional second order, third order, or beyond artery branch within a vascular family. This procedure is typically performed to diagnose or treat medical conditions that affect the abdominal, pelvic, or lower extremity arteries. It is important to note that CPT 36248 should not be reported for non-selective catheter placement or when performed in conjunction with code 36836 or 36837.

5. When to use CPT code 36248

CPT code 36248 should be used when a physician performs a selective catheter placement procedure to access and place a catheter in an additional second order, third order, or beyond artery branch within a vascular family. This code should not be used for non-selective catheter placement or when performed in conjunction with code 36836 or 36837.

6. Documentation requirements

To support a claim for CPT 36248, the physician must document the following information:

• Point 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 36248, ensure that the procedure meets the criteria for selective catheter placement in an additional second order, third order, or beyond artery branch within a vascular family. Do not report this code for non-selective catheter placement or when performed in conjunction with code 36836 or 36837. It is important to code all imaging studies performed and to code each vascular family and access separately.

8. Historical information

CPT 36248 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 an additional second order abdominal artery branch within a vascular family to diagnose and treat a patient with peripheral artery disease.
2. A physician performs selective catheter placement in an additional third order pelvic artery branch within a vascular family to visualize and treat a patient with uterine fibroids.
3. A physician performs selective catheter placement in an additional second order lower extremity artery branch within a vascular family to diagnose and treat a patient with peripheral arterial occlusive disease.
4. A physician performs selective catheter placement in an additional third order abdominal artery branch within a vascular family to visualize and treat a patient with renal artery stenosis.
5. A physician performs selective catheter placement in an additional second order pelvic artery branch within a vascular family to diagnose and treat a patient with pelvic congestion syndrome.
6. A physician performs selective catheter placement in an additional third order lower extremity artery branch within a vascular family to visualize and treat a patient with deep vein thrombosis.