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Official Description

Injection procedure for extremity venography (including introduction of needle or intracatheter)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 36005 refers to an injection procedure specifically for extremity venography. This diagnostic imaging technique is utilized to visualize the veins in the extremities, such as the arms and legs, to assess various medical conditions. A venogram is particularly useful in diagnosing or evaluating issues such as swelling and pain in an extremity, which may indicate underlying vascular problems. It is also employed to detect deep vein thrombosis (DVT), a serious condition where blood clots form in the deep veins, potentially leading to complications like pulmonary embolism. Additionally, this procedure can help identify the source of pulmonary emboli, congenital venous malformations, and other causes of venous obstruction that may affect blood flow. During the venography, the healthcare provider may also use this technique to locate a suitable vein for arterial bypass surgery, ensuring that the surgical procedure can be performed effectively. The process begins with the cleansing of the skin over the planned puncture site, typically located on the foot or hand, to minimize the risk of infection. A needle or intracatheter is then introduced into the vein, followed by the injection of a radiopaque contrast material, which enhances the visibility of the veins on imaging studies. To facilitate the filling of deep veins and improve the quality of the images obtained, a tourniquet may be applied above the ankle or on the lower arm to temporarily slow blood flow. Throughout the procedure, radiographs are taken at timed intervals to capture the flow of the contrast material through the venous system. After the procedure is completed, the intravenous access is flushed with a heparin and saline solution to maintain patency, and the needle or intracatheter is removed, with pressure applied to the site to prevent bleeding.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The injection procedure for extremity venography (CPT® Code 36005) is indicated for a variety of clinical scenarios where visualization of the venous system is necessary. The following conditions may warrant the performance of this procedure:

  • Swelling and Pain in an Extremity - This procedure is often performed to investigate the underlying causes of unexplained swelling and pain in the arms or legs, which may suggest vascular issues.
  • Deep Vein Thrombosis (DVT) - Venography is utilized to confirm the presence of blood clots in the deep veins, a condition that can lead to serious complications if not diagnosed and treated promptly.
  • Source of Pulmonary Emboli - The procedure can help identify the source of blood clots that may have traveled to the lungs, causing pulmonary embolism, a potentially life-threatening condition.
  • Congenital Venous Malformation - Venography is indicated for evaluating congenital abnormalities in the venous system, which may require surgical intervention or monitoring.
  • Other Causes of Venous Obstruction - This procedure can assist in diagnosing various other conditions that may lead to venous obstruction, helping to guide appropriate treatment options.
  • Locating a Vein for Arterial Bypass Surgery - Venography may also be performed to identify suitable veins for use in arterial bypass procedures, ensuring optimal surgical outcomes.

2. Procedure

The injection procedure for extremity venography involves several critical steps to ensure accurate imaging and patient safety. The following procedural steps outline the process:

  • Preparation of the Puncture Site - The area over the planned puncture site, typically located on the foot or hand, is thoroughly cleansed with an antiseptic solution to reduce the risk of infection prior to the procedure.
  • Insertion of Needle or Intracatheter - A needle or intracatheter is carefully inserted into the selected vein. This step is crucial as it allows for the introduction of the contrast material necessary for imaging.
  • Injection of Radiopaque Contrast Material - Once the needle or intracatheter is in place, a radiopaque contrast material is injected into the vein. This contrast agent enhances the visibility of the venous structures during imaging.
  • Application of a Tourniquet - A tourniquet may be applied above the ankle or on the lower arm to temporarily slow blood flow. This technique helps to fill the deep veins with the contrast material, improving the quality of the venogram.
  • Obtaining Radiographs - Radiographs are obtained at timed intervals during the procedure to capture the flow of the contrast material through the venous system. This imaging is essential for diagnosing any abnormalities.
  • Completion of the Procedure - After the necessary images have been obtained, the intravenous access is flushed with a heparin and saline solution to maintain patency. The needle or intracatheter is then removed from the vein.
  • Post-Procedure Care - Pressure is applied to the puncture site to prevent bleeding, ensuring patient safety and comfort following the procedure.

3. Post-Procedure

After the completion of the extremity venography procedure, specific post-procedure care is essential to ensure patient safety and recovery. The puncture site where the needle or intracatheter was removed requires careful monitoring for any signs of bleeding or hematoma formation. Patients are typically advised to keep the area clean and dry, and they may be instructed to avoid strenuous activities for a short period to allow for proper healing. Additionally, healthcare providers may recommend follow-up imaging or assessments based on the findings from the venogram to determine the next steps in management or treatment. It is also important for patients to report any unusual symptoms, such as increased pain, swelling, or signs of infection at the puncture site, to their healthcare provider promptly.

Short Descr INJECTION EXT VENOGRAPHY
Medium Descr NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH
Long Descr Injection procedure for extremity venography (including introduction of needle or intracatheter)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 2
CCS Clinical Classification 62 - Other diagnostic cardiovascular procedures
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
RT Right side (used to identify procedures performed on the right side of the body)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
LT Left side (used to identify procedures performed on the left side of the body)
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AO Alternate payment method declined by provider of service
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
QW Clia waived test
SG Ambulatory surgical center (asc) facility service
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
2002-01-01 Changed Code description changed.
1993-01-01 Added First appearance in code book in 1993.
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