We have learnt everything about catheterization of arteries. The same concept of selective and non-selective catheterization is followed in studying veins as well. If you know the rules for coding catheterization, same follows here also. The main two points which you should always remember while coding selective and non-selective catheter placement are the starting point or the puncture site for taking access and the location of the final catheter placement in each vessel or vascular family accessed. The below two procedure codes are also used when there is a direct introduction of needle or catheter in vein.
36000- Introduction of needle or intracatheter, vein
36010- introduction of catheter, superior or inferior vena cava
Non-selective and Selective Venous Catheter/device placement
So, as mention earlier the starting point or the puncture site and the final location of the tip of catheter needs to find out. Access for venous procedures is gained by several methods. Mostly the access point is via femoral vein or the internal jugular vein, like in CVC or PICC coding. In both arterial and venous, coding is based upon the starting and ending point of the catheter. Arterial selective codes provide four options to choose from (36215-36218 or 36245-36248); however, selective venous options are defined by only two coding choices- 36011 and 36012.
36011- Selective catheter placement, venous system, first order branch
36012- Selective catheter placement, venous system, second order or more selective, branch
Read also: Coding tips for fistulogram
How to differentiate Selective and Non- selective catheterization
In venous coding, placement of catheter in Superior or Inferior vena cava is considered as Non-selective catheterization, just like in arteries the placement of catheter in aorta is considered as non-selective. Once, the catheter moves out of SVC or IVC, then it enters into the selective catheterization zones. In venous coding, the highest order is second order. So, the coding is less complicated, compared to arteries. There are only two selective option or choices. Any access following catheter placement into a primary branch of superior vena cava (SVC) and inferior vena cava (IVC) (such as renal veins) or any secondary branch of the primary branch of a vessel would be defined by CPT code 36011. Any branch of vessel beyond the first order of selectivity will be defined by the second order CPT code 36012, which should be used for each second order vessel and beyond per separate branch of each vascular family studied.