A 6 Vessel Cerebral Angiogram: How Is It Coded?

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Question:

My doctor dictates “6 vessel cerebral angiogram” and the documentation describes catheterization of right and left internal carotid, right and left external carotids, and right and left vertebrals and imaging form each catheter position. How is this coded under the new codes?

Answer:

Based on CPT 2013 cervicocerebral imaging guidelines this would be reported with the codes below:

36226-50 for the bilateral vertebral catheterization and imaging
36224-50 for the bilateral internal carotid catheterization and imaging
+36227-50 for the bilateral external carotid catheterization and imaging