# Carotid and subclavian arteriogram



## yayasjfp (Apr 22, 2010)

How would a bilateral selective carotid arteriogram and left subclavian arteriogram be coded? Standard Judkins technique via the femoral artery was done
yayasjfp.


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## dpeoples (Apr 23, 2010)

yayasjfp said:


> 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


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## yayasjfp (Apr 24, 2010)

Danny,

Thanks for your reply. It was quite helpful
yayasjfp


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## 06Coder (Jun 16, 2010)

*Bovine Arch confirming code from Danny*

Hi,

I was hoping to confirm the Bovine Arch code, you said:
36217 (RT),  
    (?) I was thinking this would be 36216, second initial rather than third ititial

36218 (LT)

I look forward to reply.


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## Jim Pawloski (Jun 16, 2010)

06Coder said:


> Hi,
> 
> I was hoping to confirm the Bovine Arch code, you said:
> 36217 (RT),
> ...



Hello,
Danny is correct.  The first part of the Innomiate artery is 36215, The portion between the lt carotid and the bifurcation of the carotid and subclavian is 36216, then the common rt carotid is 36217.  The left common carotid is 36216, and the external/internal carotid is 36217-lt.

Hope this answers your question,
Jim Pawloski, CIRCC
National Healthcare Review


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## dpeoples (Jun 17, 2010)

Jim Pawloski said:


> Hello,
> Danny is correct.  The first part of the Innomiate artery is 36215, The portion between the lt carotid and the bifurcation of the carotid and subclavian is 36216, then the common rt carotid is 36217.  The left common carotid is 36216, and the external/internal carotid is 36217-lt.
> 
> Hope this answers your question,
> ...





Thanks Jim.


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