CPT® Code 36216

Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family

A selective catheter placement procedure involves the introduction of a catheter into a specific branch of the arterial system, particularly targeting the thoracic or brachiocephalic branches. This procedure is categorized as an initial second-order placement within a vascular family, indicating that the catheter is advanced beyond the first-order branches. The process typically begins with the insertion of a catheter into an extremity artery, with the femoral artery being the preferred access point, although access can also be achieved through an upper extremity artery. A small incision is made at the chosen site to facilitate the placement of an introducer sheath, which allows for the safe passage of a guidewire into the arterial system. The guidewire is then navigated through the femoral and iliac arteries into the aorta, where the catheter is subsequently advanced. The physician carefully maneuvers the catheter over the guidewire into the first-order thoracic or brachiocephalic branch, and continues to selectively advance it into higher-order branches as necessary. This meticulous process ensures that the catheter reaches the highest-order branch that requires evaluation. Following the placement, the guidewire is removed, and the physician may perform an injection of medication or radiopaque contrast media to facilitate imaging or treatment. This procedure is essential for diagnostic and therapeutic interventions within the vascular system.