Is CPT code 36140 assigned for the pullback of the catheter from the contralateral common femoral artery into the ipsilateral common femoral artery for extremity imaging?
Answer:
No additional code (eg, 36140) should be reported for the pullback positioning of the catheter in this setting.
Code 36246 (second order catheterization) should be the only code reported for selective catheterization of the contralateral common femoral artery from an ipsilateral femoral puncture site because the contralateral catheterization includes the work of the nonselective catheter placement (36140).
The Centers for Medicare & Medicaid Services (CMS) supports the reporting of selective and nonselective codes only in the following circumstances: (1) when the selective and nonselective catheterizations are performed through two separate catheters introduced in separate arterial vessels or (2) when the selective and nonselective catheterizations are performed at separate sessions.
National Correct Coding Initiative edits were developed to allow the reporting of the selective and nonselective codes with the use of a modifier when appropriate for these unusual circumstances.
The rationale for not coding 36140 with 36246 is the same as for doing a thoracic aortogram and then pulling the catheter back to do an abdominal aortogram. The work of placing the catheter in the second order selective position includes the work of the initial nonselective catheter placement.
If the contralateral leg and the aorta were not studied, then 36140 would be the appropriate code for the ipsilateral angiogram provided a nonselective aortic cannulation was not performed.
Answer:
No additional code (eg, 36140) should be reported for the pullback positioning of the catheter in this setting.
Code 36246 (second order catheterization) should be the only code reported for selective catheterization of the contralateral common femoral artery from an ipsilateral femoral puncture site because the contralateral catheterization includes the work of the nonselective catheter placement (36140).
The Centers for Medicare & Medicaid Services (CMS) supports the reporting of selective and nonselective codes only in the following circumstances: (1) when the selective and nonselective catheterizations are performed through two separate catheters introduced in separate arterial vessels or (2) when the selective and nonselective catheterizations are performed at separate sessions.
National Correct Coding Initiative edits were developed to allow the reporting of the selective and nonselective codes with the use of a modifier when appropriate for these unusual circumstances.
The rationale for not coding 36140 with 36246 is the same as for doing a thoracic aortogram and then pulling the catheter back to do an abdominal aortogram. The work of placing the catheter in the second order selective position includes the work of the initial nonselective catheter placement.
If the contralateral leg and the aorta were not studied, then 36140 would be the appropriate code for the ipsilateral angiogram provided a nonselective aortic cannulation was not performed.
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