Basics of CPT code for Arteriogram

We know many procedures which includes puncturing of an artery. For any examination of any artery, the physician needs to examine the artery by inserting a catheter into the artery. For upper or lower extremity artery exam, will use only one CPT code for arteriography or ateriogram. We have learnt previously about coding peripheral angiography and selective angiogram cpt codes. Here, also we use similar Supervision and interpretion (S&I) codes as used for angiography procedures. These codes are used for the introduction of needle or intracatheter in any extremity artery

Read also: Coding Selective and Non-Selective Catheterization procedures

Description of CPT code 36140 for Extremity Arteriogram

We use only two CPT codes here for the examination of upper or lower extremity arteries (arteriography). The first CPT code 36140, is used when an artery is accessed or punctured using a needle. Then a catheter is inserted using a guidewire into the artery. The radiological examination or the S&I is coded using CPT code 75710 (unilateral) or 75716 (bilateral).

Through a puncture in the skin over an upper or lower extremity artery, the physician injects a needle into the artery and threads a guidewire through it. The needle is removed. A catheter follows the wire into the artery and the wire is removed. Contrast material for arteriography is injected into the catheter placed upstream of the site under investigation. Once the procedure is complete, the catheter is removed and pressure is applied to stop bleeding at the injection site.

36140 – Introduction of need or intracatheter; extremity artery (code description till 2017)

Revised Code description of code 36140 in 2018

36140 –“Introduction of needle or intracatheter, upper or lower extremity artery”

75710 – Angiography, extremity, unilateral, radiological supervision and interpretation

75716 – Angiography, extremity, bilateral, radiological supervision and interpretation

S & I code 75710 and 75716, includes the capturing of images of extremity arteries and reports the findings.

Read also: Common CPT coding errors by Medical coders

When not to use Arteriogram Procedure code 36140

For studying arteries, we have a lot of procedures codes which might get confused with 36140 cpt code as well. For example, the selective and non-selective catheterization of arteries can should be used when the exam is performed for treating any stenosis in lower extremity. But, now most of the interventional procedures like angioplasty, stent, atherectomy etc. of lower extremity (CPT code 37220-37228) includes the catheter placement procedures.

The use of CPT code 36140 is only limited to one particular artery without any movement of catheter, which can be a good sign of using this procedure code. But, while treating any diagnosis like stenosis in extremities, the access is taken in one artery (mostly femoral artery for lower extremity) and the catheter in inserted using a guidewire. The catheter moves toward the damaged artery and then it is thoroughly studies.

This movement of catheter needs to checked very accurately, because the selective and non-selective catheterization codes are based on final position of the catheter. Once, we know the end point of catheter we can easily code the CPT code.