# Renal cath placement-anatomical variation



## LoriStelma (Mar 28, 2008)

I am coding a report for a patient who has two left renal arteries.  The physician selectively engaged both the superior and inferior left renals as well as the single right renal artery and reported visualized findings on all three vessels.  

Would the two left renal arteries be considered as the same or different vascular familes?   Is it innapropriate to code three first order cath placement codes for this procedure?  

Any input would be greatly appreciated.

Thanks,

Lori


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## Davistm (Apr 22, 2008)

Yes, you may report three first order catheterizations [36245-50, 36245-59].  About 20% of patients have accessory renal arteries.  These are commonly referred to as superior and inferior poles.  Each pole represents a unique vascular family and if selectively catheterized should be reported as a first order catheterization.  In addition, imaging of an accessory renal artery can be separately reported.  In this case, you would report 75724-26 for bilateral imaging of the renal arteries and 75774-26 for imaging the additional pole.

Terry


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