Radiology Coding Alert

Question: Is there a scenario in which catheter placement could be both nonselective and selective?


Georgia Subscriber

Answer: Absolutely - the key is having two different puncture sites.

Example: The physician wants to achieve selective access in the renal artery but also wants to have a simultaneous catheter in the abdominal aorta. He accesses the left renal artery through the right common femoral approach. Through a separate left femoral artery approach, he places a pigtail catheter in the abdominal aorta.

Solution: Code each of these two catheter placements separately. Code the first access site as selective, using the appropriate code in the 36245-36247 selective catheter placement series, depending on the degree of selectivity necessary for the desired clinical outcome. Then report the second access site as nonselective using 36200 (Introduction of catheter, aorta) to report the aortic catheterization.

The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga.; and Gary S. Dorfman, MD, FACR, FSIR.