What is a selective catheter placement?

Selective catheter placement occurs when a catheter advances from the original vessel punctured or from an artery that branches off the aorta. Once the catheter reaches a vessel off the original vessel punctured or off the aorta, it becomes its own vascular family.

What does selective catheterization mean?

Selective catheterization occurs when cannulation of a vessel is performed at a branch point. In most circumstances, this will be a named vessel coming off the aorta itself. A vascular family is a network of vessels that originate from an arterial branch point off a nonselective vessel.

How do you code a selective catheterization?

For selective catheter placements, the documentation has to say “selective;” the catheter “cannulated,” “went into,” or was “parked” in the artery. Without that documentation, there is no support to code one of the selective catheter placement codes (CPT 36245, 36246, 36247, and, sometimes, add-on code 36248).

Where is the starting point for selective catheter placement for the vascular families?

Selective catheter placement is a catheter placed into (not at or near the origin) a branch off the aorta or the access vessel. Each of these vessels arising from the aorta or access vessel represents different vascular families.

What is a second order artery?

The secondary branches like internal iliac, external iliac and common femoral artery are considered as secondary order artery (36246). The arteries arising from the second order arteries are called as Third order arteries (36247).

What is a third order vessel?

Common third-order vessels are the right vertebral (through the aorta, right subclavian) and right internal carotid (aorta, right common carotid). From the celiac, the gastroduodenal, the proper hepatic, and the right and left hepatic arteries are all third order or beyond.

What is the difference between 75625 and 75630?

In general, if cath.is placed at or below level of renals and injected, and then cath.is moved into legs (either unilat-75710 or bilat-75716) then you would bill 75625. You would only use 75630 if cath. was placed at or below level of renal and injected and no other studies were done.

Where is the Cervicocerebral Arch?

It is the area of the aorta above the heart where the great vessels come off to feed the head and the upper extremities. The innominate, lt carotid, and lt subclavian origions are.

What does HCPCS stand for?

Healthcare Common procedure Coding System
The Healthcare Common procedure Coding System (HCPCS) is divided into two principal subsystems, referred to as level I and level II of the HCPCS.

What is a third order artery?

What is third order vascular catheterization?

Catheterization codes are assigned based on the furthest catheter placements achieved within a vascular family. A third order catheterization is coded over a second order catheterization, and a second order catheterization is coded over a first order catheterization.