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36222 vs 36223

Eleen Posted Wed 08th of March, 2017 11:07:41 AM
Can anyone provide explanation on the difference between these two CPT codes? I understand one is extracranial and the other intracranial. I am looking for the kind of documentation needed to differentiate between the two. Any help is appreciated. Thank you
SuperCoder Answered Thu 09th of March, 2017 08:45:56 AM

Hi Eleen,

Both these codes belong to carotid territory. We code them as 36224>36223>26222 (higher to lower intensity rule). Also, 36222 is coded when the catheter is in the common carotid or innominate artery, and imaging is done of extracranial carotids. This could be the common carotid, non-selective external carotid, and proximal internal carotid arteries (cervical segment of the internal carotid). If you also do an arch study, it is included in 36222 and not coded separately.
36223 is coded when the catheter is in the common carotid or innominate artery and imaging is done of the intracranial carotid circulation. This would be the distal internal carotid and any cerebral imaging done from a common carotid selection. Hope it helps.

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