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Catheterization of artery through a surgical burr hole created by neurologist

Debbie Posted Fri 26th of October, 2012 16:34:14 PM

One of Our Neuro IR doctors was doing AVM assessment and treatment via catheters from a common femoral access but also from a sugical burr hole created by the neurolgist.

" Dr. XYZ of pediatric neurosurgery created a burr hole tract line just superficial to this middle meningeal artery. The artery was then accessed with a 22-gauge Angiocath. While there was blood return at its initial placement, subsequent contrast injection showed extravasation. A 3-D exam was performed showing accumulation of contrast in the left frontal region nearby to the point of access. Additional efforts were made to select the meningeal artery was cannulated. A Marathon microcatheter was introduced via this access and angiograms were obtained"

What codes do I use for this selective catheterization via the burr hole? do I use 1st order selection 36215?

SuperCoder Answered Mon 29th of October, 2012 13:31:19 PM

For selective procedures, the physician does one of the following:

Punctures an artery and manipulates the catheter into a different branch artery
Punctures a vein and manipulates the catheter into a different vein
Manipulates the catheter from the aorta into a branch artery
Manipulates the catheter from the vena cava into a branch vein.

Considering the scenario I presume 36215 is correct for the above case.

Consider 36215-36218 to report thoracic and brachiocephalic selective arterial procedures and 36245-36248 for separately reportable abdominal, pelvic, and leg selective arterial procedures. You should look to 36014-36015 for selective pulmonary artery catheterization codes.

You only have two codes to choose from for selective venous catheterizations: 36011 and 36012.

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