2025 CPT code 36221
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging - Vascular Procedures Surgery Feed
Non-selective catheter placement in the thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, including angiography of the cervicocerebral arch when performed, along with all associated radiological supervision and interpretation.
Modifiers may apply depending on the circumstances of the service, such as 52 (reduced services) or 59 (distinct procedural service). Consult the CPT manual for appropriate modifier usage.
Medical necessity is established by the presence of symptoms or findings suggesting vascular pathology in the cerebral circulation requiring visualization of the arteries.This may include stroke symptoms, known carotid stenosis, suspected arteriovenous malformations, or other conditions requiring cerebral angiography.
The clinical responsibility includes patient preparation, anesthesia administration (if applicable), arterial puncture, catheter insertion and manipulation, contrast material injection, image acquisition, and post-procedure care, including hemorrhage control. Radiological supervision and interpretation are also included.
In simple words: This medical code covers a test where a thin tube (catheter) is placed into a large artery in the chest (thoracic aorta) to take X-ray pictures of the blood vessels in the head and neck.A special dye (contrast material) helps make the blood vessels visible.A doctor will supervise and interpret these images to diagnose problems with the blood vessels.
This CPT code encompasses the non-selective catheterization of the thoracic aorta, followed by angiography of the extracranial carotid, vertebral, and/or intracranial vessels (unilateral or bilateral).Angiography of the cervicocerebral arch is also included when performed.The code further incorporates all associated radiological supervision and interpretation of the imaging studies. The procedure involves inserting a catheter through a distal artery, advancing it to the thoracic aorta, injecting contrast material, and obtaining X-ray images to visualize the arteries. This allows for the detection of various vascular diseases and conditions.The clinical responsibility involves patient preparation, catheter insertion and manipulation under imaging guidance, contrast injection, image acquisition, and post-procedure care.
Example 1: A patient presents with symptoms suggestive of a stroke.A non-selective cerebral angiogram (36221) is performed to visualize the intracranial and extracranial carotid and vertebral arteries to identify the location and cause of a potential vascular occlusion., A patient with a history of carotid artery stenosis undergoes a non-selective cerebral angiogram (36221) to assess the degree of stenosis and plan for potential intervention, such as carotid endarterectomy or stenting., A patient with a suspected arteriovenous malformation (AVM) in the brain undergoes a non-selective cerebral angiogram (36221) to confirm the diagnosis, determine the size and location of the AVM, and plan for treatment strategies.
Complete patient history and physical examination documenting the clinical indication for the procedure.Pre-procedure informed consent documentation.Radiology reports, including the images obtained and interpretation.Detailed procedural notes documenting catheter placement, contrast injection, and any complications encountered. Post-procedure notes including assessment of the puncture site.
** The code includes all radiological supervision and interpretation.Separate codes are required for additional first-order catheterizations in different vascular families.
- Payment Status: Active
- Modifier TC rule: The TC modifier is not applicable to this code.
- Specialties:Interventional Radiology, Vascular Surgery, Neurology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center