2025 CPT code 36222

Selective catheter placement in the common carotid or innominate artery, unilateral, with angiography of the ipsilateral extracranial carotid circulation and cervicocerebral arch, including radiological supervision and interpretation.

Follow CPT guidelines for selective vascular catheterizations. Ensure that the most comprehensive code is reported. Refer to appropriate add-on codes for additional procedures. Use modifiers as needed for bilateral procedures or reduced services.

Modifiers 22 (increased procedural services), 50 (bilateral procedure), 51 (multiple procedures), 52 (reduced services), and 59 (distinct procedural service) may be applicable depending on the circumstances. Consult the payer’s specific guidelines for modifier use.

Medical necessity for 36222 is established when there is clinical suspicion of carotid artery disease based on patient history, physical examination, or other diagnostic tests.The procedure helps determine the presence and severity of stenosis or occlusion, guiding treatment decisions.

The physician is responsible for selecting the appropriate artery for catheterization, performing the procedure, injecting the contrast material, obtaining the angiographic images, and interpreting the images to diagnose vascular disease.The physician may also be responsible for pre- and post-procedure care. The responsibility for radiological supervision may be separately reported under specific circumstances, with appropriate modifiers.

IMPORTANT Should not be reported with 37215, 37216, 37218 for the treated carotid artery.Codes 36223 and 36224 represent more extensive procedures with additional imaging; use the most comprehensive code that reflects the services performed. Add-on codes 36227 and 36228 may be applicable depending on additional procedures performed.

In simple words: This code describes a medical imaging test where a thin tube (catheter) is carefully placed into an artery in the neck to take X-ray pictures of the blood vessels in the neck and head. The images help doctors find problems with blood flow.The doctor oversees the test and interprets the images.

This CPT code encompasses the selective catheterization of the unilateral common carotid or innominate artery using any approach.The procedure includes angiography of the ipsilateral extracranial carotid circulation and the cervicocerebral arch.Radiological supervision and interpretation are also included in this code.It does not include additional catheterizations within the same arterial family supplied by a single first-order artery; those would be coded separately using 36218 or 36248.It also excludes separate coding for catheter placement or radiological services.

Example 1: A 65-year-old male patient presents with transient ischemic attacks (TIAs).A selective catheterization of the right common carotid artery is performed, with angiography of the right extracranial carotid circulation and cervicocerebral arch to assess for stenosis or occlusion. This scenario would utilize code 36222., A 72-year-old female patient with a history of carotid bruit undergoes a bilateral carotid angiography.On the left side, the catheter is advanced to the common carotid artery with angiography of the extracranial carotid and cervicocerebral arch. On the right side, only angiography of the extracranial carotid circulation is performed. Code 36222 would be used for the left side and a different code for the right side.Modifier -59 might be applied to the lesser code if required by payer rules., A 50-year-old patient presents with severe headaches and dizziness.The physician determines the need for diagnostic angiography of the bilateral common carotid arteries with imaging of the extracranial carotid circulation and cervicocerebral arches. This would require bilateral coding using 36222, most likely with modifier 50 to indicate a bilateral procedure.

Detailed patient history, including symptoms, risk factors, and prior medical history.Pre-procedure consent form.Precise documentation of the artery catheterized (common carotid or innominate), the side (unilateral), the approach used, and the extent of angiography performed (extracranial carotid circulation and cervicocerebral arch).Radiological images (angiograms) with clear labeling.Post-procedure care notes, including any complications.

** Accurate coding requires precise documentation of the procedure performed.Ensure that the reported code accurately reflects the extent of the catheterization and angiography performed.Consult with a medical coding expert if there is any uncertainty in code selection.

  • Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
  • RVU: The RVUs for this code will vary depending on the geographic location, facility type, and other factors.Consult the appropriate fee schedule for the most up-to-date information.
  • Global Days : The global period for this procedure is not explicitly defined within the provided data.Further investigation into specific payer guidelines is necessary to determine any applicable global periods.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC (Technical Component) does not apply to 36222 as this code encompasses both the technical and professional components.
  • Fee Schedule : Historical fee schedule data for this code is unavailable. Consult specific payer databases for historical fee information.
  • Specialties:Vascular Surgery, Interventional Radiology, Neurology
  • Place of Service:Office, Hospital (Inpatient/Outpatient), Ambulatory Surgical Center
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