CPT® Code 36215

A selective catheter placement in the arterial system involves the introduction of a catheter into a specific branch of the vascular family, particularly focusing on the thoracic or brachiocephalic branches. This procedure is typically initiated by accessing an artery in the extremities, with the femoral artery being the preferred site for catheter insertion, although access can also be achieved through an upper extremity artery. The process begins with a small incision made at the chosen insertion site, allowing for the placement of an introducer sheath into the artery. Following this, a guidewire is inserted to facilitate the advancement of the catheter. The guidewire is carefully maneuvered through the arterial system, passing through the femoral and iliac arteries and into the aorta. Once in the aorta, the catheter is advanced over the guidewire into a first-order branch of the thoracic or brachiocephalic arteries. The physician may continue to navigate the catheter through higher-order branches, such as second or third-order branches, until the catheter reaches the highest-order branch that requires evaluation. After the guidewire is removed, the physician may perform an injection of medication or radiopaque contrast media as necessary to visualize the vascular structures. This procedure is coded as CPT® 36215 when the first-order branch is the highest-order branch catheterized, with additional codes available for higher-order branches.