How To Use CPT Code 36253

CPT 36253 describes the procedure for superselective catheter placement in the renal artery and any accessory renal artery(s) for renal angiography. 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 36253?

CPT 36253 is a code used to describe the procedure of superselective catheter placement in the renal artery and any accessory renal artery(s) for renal angiography. This procedure involves inserting a catheter into the artery at the groin level and maneuvering it to inject a dye into the second or higher order subdivisions of the main renal artery that supplies a single kidney. The purpose of this procedure is to visualize the renal blood vessels and investigate any blockage, narrowing, or clots in the renal blood vessels.

2. Official Description

The official description of CPT code 36253 is: ‘Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral.’

3. Procedure

1. The provider assesses the patient’s eligibility for the procedure and ensures there are no existing bleeding problems or pregnancy.
2. The patient is appropriately prepped and anesthetized.
3. The provider inserts a needle into the femoral artery at the groin level and passes a thin, long, flexible guide wire and small fine catheter into the artery.
4. The provider connects the catheter to a fluoroscope, which sends X-ray images of the inside of the body to a display monitor.
5. With the help of visual fluoroscopic guidance, the provider gently pushes the catheter up to the second or higher order branches of the renal artery.
6. The provider injects a dye into the artery through the catheter and takes successive X-ray images as the dye moves through the blood vessels.
7. The provider may perform pressure gradient measurements using a pressure guide wire to study the blood pressure at the renal artery.
8. If necessary, the provider may perform a flush aortogram by advancing the catheter to the aorta and identifying any possible abnormalities in the X-ray after giving contrast.
9. The provider removes the catheter after taking the X-rays and applies pressure to the puncture site to stop bleeding.