Excellent Coding Tips for Selective and Non-Selective Catheterization of Veins

Vascular procedure coding is very interesting in interventional radiology. When I started my career in medical coding, I was not aware of different facilities in coding. Sooner, I started exploring about medical codes. Then I started learning other facilities as well. If you want to be successful medical coder, you have to learn multiple facilities. When I started, I was just coding diagnostic procedures but later I started coding vascular surgery procedures. Vascular surgery include the placement of tunneled or non-tunneled catheter, selective or non-selective catheterization, coding angiography cpt codes etc. We have learnt about upper extremity catheterization of arteries previously, where we have to follow some rules of vascular families. In this article we will learn the same thing but for venous coding. This coding tips will be helpful to boost your knowledge in medical coding and will help you in clearing CPC (Certified Professional Coder) exam.

Excellent Coding Tips for Selective and Non-Selective Catheterization of Veins

CPC Practice Exam - Medical Coding Study Guide Please Click Here!

Rules to follow for Venous Coding

In venous coding the same rules apply which we follow in arterial coding. But, here we have less procedure codes for selective catheterization of veins. Below four rules you should remember while coding venous catheterization in vascular family.

Always code Selective over Non-Selective catheterization

Code Each Vascular family separately.

Code only the highest order in a vascular family.

Code each access separately.

CPT codes used for Venous coding

There are very few CPT codes used for Venous coding. Here, we have to remember two things while coding catheterization, the access of the catheter and the final position of the catheter. Below are the CPT codes used in Venous catheterization.

36000- Introduction of needle or intracatheter, vein

36010- Introduction of catheter, superior or inferior vena cava

36011- Selective catheter placement, venous system, first order branch

36012- Selective catheter placement, venous system, second order or more selective, branch

Compared to arterial coding (36215-36218 or 36245-36248), venous coding has very less CPT codes.

Example for Venous catheterization Coding

For example, if a right or left femoral vein is the access or puncture site. Then the selective catheterization CPT codes for the primary and secondary vein will be as follows.

Innominate/Brachiocephalic 36011

Subclavian 36012

Axillary 36012

Internal jugular 36012

External jugular 36012

External iliac (ipsilateral) 36005

Common iliac (ipsilateral) 36005

IVC 36010

Renal (main) 36011

Right testicular/ovarian/gonadal 36011

Left testicular/ovarian/gonadal 36012

Right adrenal 36011

Left adrenal 36012

SVC 36010

Here, the highest order is the second order 36012, hence all the distal or peripheral veins 
will come under second order code. Also, do remember that if the catheter is in SVC (Superior Vena Cava) or IVC (Inferior Vena Cava), it is considered as non-selective catheterization. Once it moves out of SVC or IVC, then the selective catheterization starts. It’s like same arterial coding, where CPT code 36200 is used for introduction of catheter in aorta, which is considered as non-selective catheterization.

Hope, you would have learnt a lot through this article. Do share your thoughts in the comment section.

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