Reader Question: Carotid Artery Studies

Question: How should we code for injections in the left common carotid (LCC), left subclavian (LSC) and right common carotid (RCC) arteries? Should we use 36216-RT, 36215-LT, and 36215-LT (additional site on the left side) or 36216-RT, 36215-50?

Carole Kay Gokee
Northern Health, Mich.

Answer: To use 36215 (selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family) with modifier -50 (bilateral procedure) would be inappropriate because both of the injections are first-order arteries on the same side and not bilateral.

The correct coding would be 36216-RT ( initial second order thoracic or brachiocephalic branch, within a vascular family, right, highest-order code as RCC is a second-order vessel) plus 36215-59-LT (distinct procedural service, left, lower-order code as LCC is a first-order code) plus 36215-59-LT (again lower-order code as LSC is a first-order code). Each code is appropriate as each placement involves a different vascular family. Appending modifier -59 indicates that each placement was a different procedure on a different vascular family.


- Published on 2001-02-01