How would a bilateral selective carotid arteriogram and left subclavian arteriogram be coded? Standard Judkins technique via the femoral artery was done
yayasjfp.
For normal anatomy
36216 (RT Common Carotid)
36215 -59 (LT Common Carotid)
36215-59 (LT Subclavian) or 36216-59 (if Lt Vertebral is selected)
and
75680 (for Bilateral Cervical Carotids assuming an interpretation of the images)
75671 (for Bilateral Intracranial Carotids, assuming interpretation """)
75710 (for Left Subclavian, assuming interpretation "")
However, if Left Subclavian was imaged to read the Left Vertebral then
75685 should be coded instead.
Also, if Lt Subclavian image was to guide the catheter into the Left Vertebral, then more images taken and interpreted, then the Lt Subclavian images are for guidance or roadmapping and should not be billed. Code instead 36216 for the Lt Vertebral catheter placement and drop the Lt Subclavian Catheter placement code 36215. Again, code 75685 for the Lt Vertebral and do not code the 75710 for the Lt Subclavian.
For a Bovine Arch the catheter placement codes for the carotids should be
36217 (RT)
36218 (LT since they are now part of the same vascular family)
all other codes are the same as above.
HTH