How To Use CPT Code 36901

CPT 36901 describes the introduction of needle(s) and/or catheter(s) into the dialysis circuit, along with diagnostic angiography of the dialysis circuit. 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 36901?

CPT 36901 can be used to describe the procedure in which a healthcare provider introduces a needle and/or catheter into the dialysis circuit under fluoroscopic guidance. This is done to visualize and record images of the entire dialysis circuit, including the arterial anastomosis, adjacent artery, and the entire venous outflow, including the inferior or superior vena cava. The procedure also includes the injection of contrast material and the necessary imaging. It is important to note that radiological supervision, interpretation, image documentation, and report are all included in this code.

2. Official Description

The official description of CPT code 36901 is: ‘Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through the entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. Under fluoroscopic guidance, the provider introduces a needle and/or catheter through the skin over the surgically created connection between an artery and a vein that serves as the dialysis access point.
3. Contrast material is injected to visualize the circulation throughout the arterial and venous components of the entire dialysis circuit, including the superior and/or inferior vena cava.
4. The provider withdraws the needle and/or catheter and applies pressure over the access point to control bleeding.
5. The procedure is supervised by the provider, who documents the images, interprets the findings, and prepares a report.

4. Qualifying circumstances

CPT 36901 is performed on patients who require diagnostic angiography of the dialysis circuit. This procedure is typically done on patients with a surgically created connection between an artery and a vein, such as an arteriovenous graft, fistula, or anastomosis. The purpose of the procedure is to assess blood flow or locate an obstruction within the dialysis circuit. It is important to note that CPT 36901 should not be reported in conjunction with codes 36833, 36836, 36837, 36902, 36903, 36904, 36905, or 36906.

5. When to use CPT code 36901

CPT code 36901 should be used when a healthcare provider performs the introduction of needle(s) and/or catheter(s) into the dialysis circuit, along with diagnostic angiography of the dialysis circuit. This code should be used when all the necessary components of the procedure are performed, including direct puncture(s), catheter placement(s), injection(s) of contrast, and all necessary imaging. It is important to note that this code should not be reported more than once per session.

6. Documentation requirements

To support a claim for CPT 36901, the healthcare provider must document the following information:

• Patient’s prepping and anesthesia
• Details of the procedure, including the introduction of needle(s) and/or catheter(s), injection(s) of contrast, and imaging
• Specific areas imaged, such as the arterial anastomosis, adjacent artery, and the entire venous outflow including the inferior or superior vena cava
• Supervision, interpretation, and findings of the procedure
• Preparation of a report documenting the procedure

7. Billing guidelines

When billing for CPT 36901, ensure that all the components of the procedure are performed, including the introduction of needle(s) and/or catheter(s), injection(s) of contrast, and imaging. It is important to note that this code should not be reported in conjunction with codes 36833, 36836, 36837, 36902, 36903, 36904, 36905, or 36906. Additionally, it should not be reported more than once per session.

8. Historical information

CPT 36901 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider introduces a needle and catheter into the dialysis circuit of a patient with end-stage renal disease, performing diagnostic angiography to assess blood flow and identify any obstructions.
2. Under fluoroscopic guidance, a provider introduces a catheter into the dialysis circuit of a patient with a surgically created arteriovenous fistula, injecting contrast material to visualize the entire venous outflow, including the inferior vena cava.
3. A healthcare provider performs diagnostic angiography of the dialysis circuit for a patient with an arteriovenous graft, using a needle and catheter to inject contrast material and obtain images of the arterial anastomosis and adjacent artery.