Cardiology Coding Alert

Reader Questions:

Understand Differences Between Selective, Nonselective Caths

Question: My cardiologist accessed the brachial artery percutaneously and placed a sheath. Next, they threaded a guidewire through the sheath into the thoracic aorta. My cardiologist then placed a catheter over the guidewire into the arch of the aorta and performed cervicocerebral angiography. They then moved the catheter into the vertebral artery. My cardiologist injected contrast material through the catheter into the blood circulation. They performed imaging supervision and interpretation for angiography with several X–rays of the ipsilateral vertebral circulation and cervicocerebral arch. Which code should I report for this procedure?

Pennsylvania Subscriber

Answer: You should report 36226 (Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed) for this procedure.

Don’t miss: Code 36226 is an example of selective catheterization, which occurs when your cardiologist advances a catheter into a main branch off of the aorta or vena cava or off the vessel they initially entered. Your cardiologist may need to catheterize various vessels to reach the aorta or vena cava.

On the other hand, with nonselective catheterization, your cardiologist will place the catheter directly into a vessel and not advance it any farther.