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Wiki non-tunneled/non-selective
- Thread starter kseifert
- Start date
dbranker
Networker
Non-tunnelled vs. Non-selective
Hello Karen,
These terms relate to different types of interventional procedures.
Non-tunnelled typically refers to burrowing (like a groundhog) under the skin before reaching the large vein accessed. You will see this term in your CPT book for procedures such as central lines (CVCs). You might also see these in abdominal catheters. Although they sound similar, central lines must terminate in specific places to be coded as such and they are usually left in place. Check out this visual to help you understand: http://en.wikipedia.org/wiki/Central_venous_catheter.
Non-selective is a term you see for catheterizing blood vessels. This refers to accessing (inserting a catheter into) a blood vessel, other than a central line, and either 1.) not manipulating (moving) the catheter into another vessel or 2.) inserting a catheter into a blood vessel and ending in the aorta or vena cava.
The challenge in coding IR is the documentation does not match the CPT book. For example, a physician will state that they did a Superior Mesenteric Artery Angiography. To accomplish this, a distal vessel is typically accessed and the catheter threaded into the aorta, then the superior mesenteric artery. This would be coded as a 1st order cathetherization of the abdominal, pelvic and LE artery 36245. If the catheter stopped in the aorta (any part) and was not advanced to another vessel, it would be coded as a non-selective cath 36200.
I hope this helps.
Doris V. Branker, CPC, CPC-I, CIRCC, CEMC
Hello Karen,
These terms relate to different types of interventional procedures.
Non-tunnelled typically refers to burrowing (like a groundhog) under the skin before reaching the large vein accessed. You will see this term in your CPT book for procedures such as central lines (CVCs). You might also see these in abdominal catheters. Although they sound similar, central lines must terminate in specific places to be coded as such and they are usually left in place. Check out this visual to help you understand: http://en.wikipedia.org/wiki/Central_venous_catheter.
Non-selective is a term you see for catheterizing blood vessels. This refers to accessing (inserting a catheter into) a blood vessel, other than a central line, and either 1.) not manipulating (moving) the catheter into another vessel or 2.) inserting a catheter into a blood vessel and ending in the aorta or vena cava.
The challenge in coding IR is the documentation does not match the CPT book. For example, a physician will state that they did a Superior Mesenteric Artery Angiography. To accomplish this, a distal vessel is typically accessed and the catheter threaded into the aorta, then the superior mesenteric artery. This would be coded as a 1st order cathetherization of the abdominal, pelvic and LE artery 36245. If the catheter stopped in the aorta (any part) and was not advanced to another vessel, it would be coded as a non-selective cath 36200.
I hope this helps.
Doris V. Branker, CPC, CPC-I, CIRCC, CEMC