2025 CPT code 36223
Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Selective catheter placement, common carotid or innominate artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and radiological supervision and interpretation, including extracranial carotid and cervicocerebral arch angiography.
Modifiers are applicable to this code. Refer to the provided list of modifiers for potential use cases and circumstances.
Medical necessity is established by documenting the patient's clinical signs and symptoms indicating a potential cerebrovascular issue that warrants detailed imaging of the carotid circulation. This may include symptoms like stroke, TIA, or other neurological deficits. Pre-operative planning for procedures like carotid endarterectomy can also justify medical necessity.
The physician performing and interpreting the angiographic imaging is responsible for the entire procedure, from patient preparation and catheter insertion to contrast injection and image interpretation. This includes ensuring patient safety and managing any potential complications.The provider also documents the findings.
In simple words: This procedure involves inserting a thin tube (catheter) into an artery in the neck to examine blood vessels in the brain using X-rays and a special dye. The doctor uses these images to check for blockages or other problems.
This code describes a procedure where a catheter is selectively placed into either the common carotid or innominate artery on one side of the body. The procedure includes angiography, a radiological imaging technique, of the intracranial carotid circulation on the same side as the catheter insertion.It also encompasses imaging of the extracranial carotid and cervicocerebral arch when performed. The code includes all associated radiological supervision and interpretation.
Example 1: A patient presents with symptoms suggesting a stroke, such as sudden weakness on one side of the body. A selective catheterization with angiography is performed to evaluate the intracranial carotid circulation for any blockages or abnormalities., A patient experiencing transient ischemic attacks (TIAs or "mini-strokes") undergoes this procedure to assess the carotid arteries and identify any areas of narrowing or stenosis that might be causing the TIAs., Before a planned carotid endarterectomy (surgical removal of plaque from the carotid artery), this procedure may be done to map the blood vessels and guide surgical planning.
Documentation should include details about the catheter placement, the areas imaged (intracranial, extracranial, cervicocerebral arch), the type and amount of contrast used, the findings of the angiography, and any complications encountered. The medical necessity for the procedure, correlating with the patient's symptoms and clinical history, must also be clearly documented.
- Revenue Code: P2F
- Specialties:Interventional Radiology, Neurosurgery, Vascular Surgery, Neurology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center