Cardiology Coding Alert

Question: I'm new to the peripheral vascular side of coding, and I'm having trouble distinguishing between nonselective and selective vascular services. What exactly distinguishes the two types?Wisconsin SubscriberAnswer: In peripheral procedures, you may see any of the following: Non-selective: The physician places a needle or catheter directly into an artery or vein with no further advancement (for example, a direct stick or direct puncture) past the punctured vessel, OR the physician places a catheter into any portion of the aorta or vena cava from any approach.Selective: The physician guides, negotiates, manipulates, or advances the catheter into any arterial or venous vessel other than the aorta, vena cava, or initial vessel accessed.Supraselective: The physician performs catheterization of a second or higher order vessel, essentially performing selective catheter placements within the original selective vascular family (for example, further selective catheterization within the celiac trunk, moving into the common hepatic and beyond). Tip: [...]