# Difference between 36222 and 36223



## Atillema12 (Mar 20, 2017)

Hello all, 

I am new to IR. I code for IR Neurosurgery. I am looking for someone to explain the difference between 36222 and 36223. I am aware one is for cervical carotid and the other for cerebral carotid, however, i am not sure how to differentiate them on the documentation. Any help is appreciated. Here is an example of report:

Selective catheterization of the right common carotid artery 
Selective catheterization of the left common carotid artery
After obtaining informed consent, and using a strictly 
aseptic technique, the patient was prepped and draped in a standard 
fashion. The right femoral artery was accessed percutaneously using a 
modified Seldinger technique, and a 6 Fr short sheath was inserted to 
be used throughout the procedure. *The great vessels were 
catheterized using the following catheters, depending upon the 
arterial configuration: 5Fr Newton #5 and HIH Digital subtraction 
angiographic images were obtained, in standard views, of all 
extracranial and intracranial branches of systems studied. Selective 
power injection of the right internal carotid artery was carried out, 
with rotational angiographic image acquisition, followed by 
post-processing in the independent workstation, with 
three-dimensional rendering of the right carotid artery system.
Thank you in advance!


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## mdawn (Mar 21, 2017)

Arenteria12 said:


> Hello all,
> 
> I am new to IR. I code for IR Neurosurgery. I am looking for someone to explain the difference between 36222 and 36223. I am aware one is for cervical carotid and the other for cerebral carotid, however, i am not sure how to differentiate them on the documentation. Any help is appreciated. Here is an example of report:
> 
> ...



Intracranial imaging was done on both sides. You would not code for the extracranial imaging because that is included. For this report, you would code 36223 for the left side because the cath was in the common carotid. The right side would be 36224 because the cath was in the "internal" carotid. 
I hope that makes sense and helps!


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## Jim Pawloski (Mar 21, 2017)

The difference between 36222 and 36223 is for 36222, the catheter is in the common carotid and only the bifurcation is imaged. For 36223, again the catheter is in the common carotid, but both the common carotid and cerebral circulation are imaged either by one or two injections. 36224 is the catheter is in the internal carotid and the cerebral arteries are imaged.

HTH,
Jim Pawloski, CIRCC, R.T. (CV)


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