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2025 CPT code 36245

Selective catheter placement in each first-order abdominal, pelvic, or lower extremity artery branch within a vascular family.

Follow CPT guidelines for selective vascular catheterization.Ensure to code all catheterizations, including those of lesser order vessels.

Modifiers may be applicable depending on the circumstances (e.g., bilateral procedure, multiple procedures). Refer to modifier guidelines for appropriate usage.

Medical necessity is determined based on clinical findings (e.g., symptoms, diagnostic imaging suggesting vascular disease) and the need for the information obtained through selective catheterization to guide treatment or further evaluation.The documentation should support the need for this procedure.

The physician is responsible for selecting the access site, inserting and navigating the catheter, injecting contrast media, interpreting the resulting images, and providing post-procedure care.Radiology supervision and interpretation may be separately coded.

IMPORTANT:36218, 36248 (for additional second or third-order catheterizations within the same family);Other codes may be necessary depending on additional procedures performed.

In simple words: This code describes a medical procedure where a thin tube (catheter) is carefully placed into specific arteries in the abdomen, pelvis, or legs to examine or treat a problem.The doctor inserts the catheter through a larger artery and guides it to smaller ones.This helps see the inside of the arteries.

This CPT code represents the selective catheter placement in each first-order artery branch (abdominal, pelvic, or lower extremity) within a single vascular family.The procedure includes the introduction and all lesser-order selective catheterizations used in the approach.Additional second- or third-order arterial catheterizations within the same family supplied by a single first-order artery should be reported using codes 36218 or 36248.Additional first-order catheterizations in different vascular families require separate coding.

Example 1: A patient presents with suspected lower extremity arterial stenosis.The physician performs a selective catheterization of the femoral artery, progressing to selective catheterization of the popliteal and anterior tibial arteries to visualize and assess the degree of stenosis., A patient with suspected abdominal aortic aneurysm undergoes a selective catheterization of the abdominal aorta and its major branches (celiac, superior mesenteric, renal, and common iliac arteries). The procedure requires separate coding for each major vessel accessed., A patient with a suspected pelvic vascular malformation undergoes selective catheterization of the internal iliac arteries bilaterally.Both sides would require separate coding.

Detailed documentation should include the access site (e.g., femoral, brachial), the specific arteries catheterized, the number of catheterizations, contrast used, and findings.Imaging studies performed must also be appropriately coded.Pre- and post-procedure care should also be documented.

** This code should only be used for selective catheterizations of first-order artery branches.If there are multiple access sites, each one will require a separate code. For additional catheterizations of secondary and tertiary arteries within the same vascular family, use CPT codes 36218 or 36248, as appropriate.

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