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2025 CPT code 36224

Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed.

Follow CPT coding guidelines for selective vascular catheterizations, which include coding for the introduction and all lesser-order selective catheterizations used in the approach.Refer to guidelines specific to cardiovascular procedures.

Modifiers may be applicable. Refer to current CPT guidelines for modifier usage.

Medical necessity should be established by documenting the patient's clinical presentation and the rationale for performing the procedure.The documentation should clearly link the procedure to the diagnosis and expected outcome.

The physician is responsible for the entire procedure, including prepping and anesthetizing the patient, accessing the artery, inserting the catheter and guidewire, injecting the contrast material, performing the angiography, and ensuring proper post-procedure care to stop bleeding.

In simple words: The doctor uses a small tube (catheter) to access a blood vessel in your neck (carotid artery). They then inject a special dye and take X-ray images of the blood vessels in your brain to check for any problems.This includes examining blood vessels both inside and outside your skull.

This procedure involves selective catheter placement in the internal carotid artery on one side, along with angiography of the intracranial carotid circulation on the same side.It includes all associated radiological supervision and interpretation. Angiography of the extracranial carotid and cervicocerebral arch is also included when performed.Note: Do not report 36224 in conjunction with 37215, 37216, or 37218 for the treated carotid artery.

Example 1: A patient presents with symptoms suggestive of a stroke.A selective catheterization and angiography of the internal carotid artery are performed to evaluate for stenosis or occlusion., A patient with a history of transient ischemic attacks (TIAs) undergoes this procedure to assess the blood flow in the brain and identify any potential blockages., Prior to a planned carotid endarterectomy, this procedure is used to map the cerebral vasculature and aid in surgical planning.

Documentation should include details of the patient's symptoms, the reason for the procedure, the approach used, the vessels examined, the findings of the angiography, and any complications encountered.Pre- and post-procedure care should also be documented.

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