Radiology Coding Alert

Question: Should I report catheter placement separately for a transjugular liver biopsy?

Arizona Subscriberc

Answer: Yes. You should report 36011 (Selective catheter placement, venous system; first-order branch [e.g., renal vein, jugular vein]) to reflect the catheter placement performed for transjugular liver biopsy.

Support: "Codes for catheter placement and the radiologic supervision and interpretation should also be reported, in addition to the code(s) for the therapeutic aspect of the procedure," state CPT's "Transcatheter Procedures" guidelines.

To complete your CPT choices, add 37200 (Transcatheter biopsy) for the biopsy service and 75970 (Transcatheter biopsy, radiological supervision and interpretation) for radiological supervision and interpretation.

The procedure: To perform the biopsy, the radiologist inserts a catheter into the jugular vein and threads it into the hepatic vein, allowing her to collect liver samples using a biopsy needle and suction device. First-order code 36011 applies because the radiologist moves the catheter into the vena cava and then into the hepatic. People have left, right, and middle hepatic veins, but this should not affect your code choice. All of these veins empty into the vena cava, making them first order codes. You may see the right hepatic vein used most often.