Non-selective and selective venous catheter device placement is a key area to master. First, remember that all procedural coding defining catheter placement, whether selective or nonselective, is determined by two main criteria:
Let’s review some important rationale behind catheter/device placement.
Although there are multiple methods to gain access for venous procedures, two coding examples will be provided. Specifically, the assumed points of access will be via a femoral vein approach or an internal jugular vein approach. Note that both arterial and venous vascular coding is founded upon the starting and ending points. More importantly, arterial selective codes provide four options to choose from. These are the following codes:
However, know that selective venous options are defined by only two coding choices 36011 and 36012.
| 36011 | Selective catheter placement, venous system, first order branch |
| 36012 | Selective catheter placement, venous system, second order or more selective, branch |
Since there are only two selective choices, any vessel accessed following catheter placement into a primary branch of the superior vena cava (SVC) and inferior vena cava (IVC) (such as renal veins) or any secondary branch of the primary branch of a vessel entered by a direct stick method (the straight sinus following direct puncture of the internal jugular vein) would be defined by code 36011.
What about the first order of selectivity? It is important to understand that any vessel beyond the first order of selectivity will be defined by code 36012. When is appropriate to use this code? 36012 should be used for each second-order vessel and beyond per separate branch of each vascular family studied.
When assigning codes for vessels accessed within the portal system, submit code 36481 (percutaneous portal vein catheterization by any method) in addition to codes 36011 or 36012.
Please refer to the following tables for venous vascular code options for the vessels listed.
| 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 |
| Internal jugular (ipsilateral) | 36000 |
| SVC | 36010 |
| IVC | 36010 |
| Renal (main) | 36011 |
| Right testicular/ovarian/gonadal | 36011 |
| Left testicular/ovarian/gonadal | 36012 |
| Common iliac | 36011 |
| External iliac | 36012 |
| Deep femoral | 36012 |
| Great saphenous | 36012 |
| SVC | 36010 |
| Right hepatic | 36011 |
| Branches of right hepatic | 36012 |
| Portal | 36481 |
| Splenic | 36011 |
| Superior mesenteric | 36011 |
| Inferior mesenteric | 36012 |
| Ileocolic | 36012 |
| Left colic | 36012 |
| Right colic | 36012 |
| Pancreaticoduodenal | 36012 |
These are not all the necessary coding tips and rationale essential for correct venous studies coding and compliance. As service volumes rebound, now more than ever it is imperative to make sure your CPT® coding is correct and compliant. Master more interventional radiology topics and break down the complexity with expert-infused insight. Our Venous Studies Interventional Radiology Coding webcast is an essential training tool for both audio and visual learners.
Clinical documentation integrity (CDI) professionals work in a variety of settings, and although I mostly focus on topics related to hospital inpatient billing, this week
With so much focus within the federal government on abuse, fraud, and waste, I thought it might be helpful to review a couple of federal
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