Question:

If instead, selective renal angiography is performed, can I submit 36251–36254 as appropriate in addition to a cardiac catheterization procedure?

Answer:

There are four “bundled” codes (36251–36254) that include several portions of the study. Included in these codes are the vascular access, fluoroscopy, catheter placement, flush aortography, the S&I code itself, pressures and image-post processing. These codes also include any accessory renal arteries that may be engaged, injected, and imaged. An easy way to separate and understand how these four choices may be used is as follows. Codes 36251 and 36252 include first-order selective catheterization and imaging from these first-order placements. The codes are for unilateral (36251) or bilateral (36252) procedures. Codes 36253 and 36254 include selective catheterization of a second order or higher. The codes are for unilateral second + order (36253) or bilateral second + order (36254) of selectivity studies.

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