Catheterization of the Access Vessel During Endovascular Procedures

Question:

How do I code for catheterization of the access vessel, for example the common femoral artery? Do I bill the nonselective catheterization code 36140?

Answer:

Access to the common femoral artery to perform an angiogram, angioplasty , stent, etc, is not separately reported if the catheter is moved out of that access vessel. For example, if the right common femoral artery is accessed and the end point of the catheter is in the left (contralateral) superficial femoral artery, this is reported as a third order selective catheterization, 36247. The nonselective code is bundled into the selective catheterization.  If the right common femoral artery is accessed and the right superficial femoral artery is the end point of the catheter, this is reported as a first order selective catheterization, 36245.  Remember, selective catheterizations are coded based on the documented end point of the catheter. Documentation of the access vessel (puncture site) is important because it determines what catheterization code to report. The non-selective catheterization code, 36140, is reported only if the catheter is placed in the common femoral artery and not moved from that location. For example, if the catheter is placed in the right common femoral artery and a right extremity angiogram is performed with the catheter remaining in the common femoral artery, 36140 is reported as the catheterization code.