General Surgery Coding Alert

Question: Our practice recently added a surgeon who specializes in peripheral vascular procedures, and I'm having trouble understanding how to distinguish between non-selective and selective procedures for coding purposes -- could you help? Florida SubscriberAnswer: CPT® codes divide peripheral vascular procedures into three levels as follows: 1. Non-selective: The surgeon places a needle or catheter directly into an artery or vein with no further advancement beyond the punctured vessel (such as a direct stick or direct puncture). Alternately, a non-selective procedure could involve placing a catheter into any portion of the aorta or vena cava from any approach.You should use intra-arterial and intra-aortic codes 36200 and 36100-36160 to report nonselective arterial procedures, and use intravenous codes 36010 or 36005 for nonselective venous procedures. The direct translumbar approach has its own access code -- 36160 (Introduction of needle or intracatheter, aortic, translumbar).2. Selective: The surgeon performs a selective peripheral vascular procedure when he [...]