Wiki IR Question

[LScottCPC]

I am taking the RCC exam on Oct. 19th. Here is the example that I am looking at:

Access: right common femoral

Catheter advanced to RCC, contrast injected for imaging of RCC, RIC. Catheter advanced to the R vertebral for injection and imaging. Catheter advanced into the LCC, contrast injected for imaging of LCC, LIC. Catheter advanced to the L vertebral with injection and imaging.

The answers given for this scenario are as follows:

36216 RCC
36218 R Vertebral
36215-59 LCC
36215-59 L Vertebral
75671 LIC and RIC
75680 LCC and RCC
75685-LT vertebral
75685-RT vertebral

My question is how does the L vertebral become a 36215 since it is off the subclavian? This is where I get confused with the interventional angiography codes.

Can someone help?!

Thanks!
Lisa

 

[rhondatalley]

IR coding

If the cath. placement into the left vertebral is from the subclavian, it should be a 36216. However, if there is a documented variant anatomy, and the cath placement into the left vertebral is directly from the aortic arch, then you would use a 36215.

 

[Kimberfly]

This is really confusing unless there is severe variant anatomy...RCC and Rt Vert would be coded 36217 for rt vert (highest order in the rt brachiocephalic family) and then 36218 for the rt common carotid since it is a lesser order.

Good luck on your test! I took the CIRCC today so I know how you feel.

Kim