September 2015 Q & A

Question: 36228 with Pipeline Embolization

Following diagnostic cerebral angiogram with bilateral internal carotid artery catheter and 3D angiogram requiring separate work station, angle projections for treatment of the cavernous segment of the right internal carotid artery aneurysm were obtained. Navien catheter was positioned within the intracranial segment of the right internal carotid artery, and Marksman catheter was navigated into the right middle cerebral artery. Then pipeline embolization was done on the right cavernous carotid segment. At the completion of the coiling procedure, cerebral angiogram was performed via the right internal carotid artery. Besides 36224-50, can I add 36228 in this case even though the embolization was at cavernous carotid? I also coded 61624, 75894, 75898, and 76377. Are these the right codes for this case?


Answer:

No. CPT code 36228 specifically is for selection and diagnostic imaging of a branch arising off the ICA, vertebral, or basilar arteries. Some of these branches are the MCA, ACA, ophthalmic, meningohypophyseal trunk, AICA, PICA, PCOM, PCA, and superior cerebellar, to name a few. The rest of the codes are correct.