Procedure performed for Renal Artery Catheterization
The physician first takes the access into the skin through an underlying artery of lower extremity and introduce a guidewire through the needle. The wire is threaded into the main renal artery or any branch of renal artery. A catheter is introduced through the guidewire and then the contrast material in injected for arteriography. Images are obtained once the contrast is injected. CPT code 36251, 36252, 36253 and 36254 are used for coding selective catheter placement in renal artery and its branches. In this scenario, the catheter first enters into the aorta and then moves toward renal arteries and perform renal arteriograms. You can check out the vascular family rules and the difference between the selective and Non-selective catheterization to learn more about these code. This technique will really help to improve your skills in medical coding.
Description of CPT code 36251, 36252, 36253 and 36254
These procedure codes have been revised recently. There is no major change in the description except the removal of the moderate conscious services. Yes, for 2017 we have new CPT codes for moderate conscious sedation, which need to code separately for all the procedures performing sedation. Below is the detail description of these procedure codes.
36251 Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image post processing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral
36253 Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image post processing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral
Do and Don’t with CPT code 36251, 36252, 36253 and 36254
CPT code 36251 and 36252 are used only for coding first order selective catheter placement in the main renal artery. And 36253 and 36254 are used for coding super selective catheter placement for second and third order branch of main renal artery. Use code 36251 and 36253 for unilateral procedure and code 36252 and 36254 for bilateral procedure.
Do not report CPT code 36253 along with 36251
Do not report CPT code 36254 along with 36252
Placement of close device (HCPCS code G0269) at the vascular access in included in these procedure codes. Hence, do not report Code G0269 along with these procedure codes.
Do not report abdominal aortography (CPT code 75625) in along with these procedures, aortogram is included in these CPT codes.
Do not report Renal angiography of all ipsilateral vessels, they are included in the procedure codes.
Code Moderate conscious sedation separately for CPT codes 36251, 36252, 36253 and 36254
Do not report radiological supervision and interpretation
Report ultrasound guidance (CPT code 76937) separately for these procedure codes.