Wiki Sheath Coding

[ebbie30]

Good Afternoon,

We are having a discussion in my office regarding coding a cath placement for a sheath only. We understand you cannot code for the guidewire or needle, but what about the sheath? Does anyone know if we can code a sheath placement.

Example:

A micropuncture wire was positioned in the external iliac artery and a micropuncture sheath was placed. An angiogram was performed own the right leg.


Can we code for the sheath placement in the external iliac artery (36246)

Thanks
Jen

 

[Chlrtrep]

I would suggest non selective placement of an artery in this case CPT 36140 if injection of contrast was through the sheath and this was all that was done. 36246 is for selective cath placement (2nd order)once the catheter comes from the aorta.

 

[ebbie30]

I understand the cath placement codes- what I am asking is, can we code when they say "the sheath was placed in XXX artery"
Our Dr.s feel if they tell me where the sheath is and they perform an injection, they want credit for the sheath placement, no actual catheter was used.

 

[Chlrtrep]

I understand the cath placement codes- what I am asking is, can we code when they say "the sheath was placed in XXX artery"
Our Dr.s feel if they tell me where the sheath is and they perform an injection, they want credit for the sheath placement, no actual catheter was used.

IMHO Yes if that is all that is done that is what I meant by: "I would suggest non-selective placement of an artery in this case CPT 36140 if injection of contrast was through the sheath and this was all that was done."

i.e. sheath placed into right iliac artery contrast injected and right lower extremity performed. We code this as 36140 75710

HTH