Cardiology Question for the Week of August 20, 2018

Question:

I am looking for the correct codes to assign when our provider documents that bilateral selective carotid artery angiogram and intracerebral artery angiogram were performed followed by selective left subclavian artery and left vertebral artery angiogram. Would the correct coding be CPT^® 36223-50 and 36226-LT? Or would it be 36223-50 and 36225-LT?

Answer:

As indicated below, these codes are chosen according to where you placed the catheter and what was imaged.

• Assign 36223 if the catheter is placed into the common carotid artery with imaging of the intracerebral (internal carotid) vessels (with or without common carotid imaging).
• Assign 36224 if the catheter is placed into the internal carotid artery with imaging of the intracerebral (internal carotid) vessels (with or without common carotid imaging.
• Assign 36225 if the catheter is placed into the subclavian artery with imaging of the vertebral artery.
• Assign 36226 if catheter placed into the vertebral artery with imaging of the vertebral artery.

From the verbiage in your question above, we would recommend that you assign the following:

The best documentation practice is to have the physician document selective artery catheterized “with” imaging of xxx verses “and.”

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