2025 CPT code 36218
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Selective catheter placement in the arterial system; additional second-order, third-order, and beyond, thoracic or brachiocephalic branch within a vascular family.
Modifiers may be applicable depending on the circumstances, such as modifier 59 (distinct procedural service) if the procedure is distinct from other services provided.Consult the official CPT manual and payer guidelines for appropriate modifier use.
Medical necessity for this procedure would be supported by clinical findings suggesting the need for detailed visualization of the specified artery branches. Examples include evaluating suspected stenosis, occlusion, aneurysm, or other vascular pathology in the thoracic or brachiocephalic arteries.
The clinical responsibility for this procedure typically rests with a cardiovascular surgeon, interventional radiologist, or other qualified physician with expertise in vascular procedures.Responsibilities include patient assessment, obtaining informed consent, performing the catheterization, administering contrast media, interpreting images, and providing post-procedure care.
In simple words: The doctor inserts a thin tube (catheter) into a smaller artery branch within a group of arteries already accessed, taking pictures of the arteries using special dye and X-rays. This is done in addition to checking the larger arteries.
This CPT code, 36218, represents the selective catheter placement in an additional first, second, third, or smaller order thoracic or brachiocephalic artery branch within a previously accessed vascular family.This procedure is typically performed to obtain angiographic images of these arteries and should be reported in addition to the code for the primary selective catheterization. The approach may involve accessing vessels through the femoral, radial, jugular, or brachial arteries, with the catheter advanced to the target artery branch for contrast injection and imaging using fluoroscopy or X-ray.
Example 1: A patient presents with suspected stenosis of the right middle cerebral artery.After accessing the femoral artery, the physician performs selective catheterization of the right common and internal carotid arteries (36216 or 36217) followed by selective catheterization of the right middle cerebral artery (36218) to visualize the stenosis., A patient presents with suspected thoracic aortic aneurysm. The physician obtains access via the right femoral artery and performs selective catheterizations of the brachiocephalic artery, followed by the right subclavian artery (36218) to fully evaluate the extent of the aneurysm., During a cardiac catheterization, the physician needs to visualize the origin of the internal mammary artery for potential bypass graft. After successful cardiac catheterization, they use the code 36218 to bill for the additional selective catheterization of the internal mammary artery.
Detailed procedural notes, including the approach (e.g., femoral, radial), the specific arteries catheterized and their order (e.g., common carotid, internal carotid, middle cerebral), and the imaging results (e.g., angiograms) are required.The documentation must clearly justify medical necessity.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement practices.The information provided here is for informational purposes only and should not be considered medical or billing advice.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: The RVUs for this code will vary based on geographic location, facility type, and other factors. Consult your local Medicare Administrative Contractor (MAC) or other payer for the most up-to-date information.
- Global Days: The global surgical period for this procedure will depend on the overall complexity of the case and the other procedures performed.The CPT guidelines do not explicitly define a global period for this code.Consult official guidelines and payer policies for specific details.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier may apply if the service is performed by a physician other than the interpreting physician.Refer to specific payer policies and guidelines.
- Fee Schedule: Historical fee schedule data for CPT code 36218 is unavailable without access to specific payer and geographic data.
- Specialties:Cardiology, Interventional Radiology, Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center