CPT® Code 36221

Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed

Thoracic aorta angiography is a diagnostic imaging procedure that involves the placement of a catheter into the thoracic aorta to visualize the blood vessels supplying the head and neck. This procedure is categorized as non-selective catheter placement, meaning that the catheter is positioned in the aorta without advancing into its higher order branches, such as the carotid or vertebral arteries. The vascular access for this procedure is typically achieved through a single-wall puncture of either the common femoral artery or the ipsilateral brachial artery. Once access is established, a guidewire is inserted, and a catheter is advanced into the thoracic aorta under fluoroscopic guidance. During the procedure, radiopaque contrast media is injected through the catheter into the aorta, allowing for the visualization of the aorta and its branches via digital angiographic imaging. The catheter may be maneuvered within the aorta to obtain images of the extracranial carotid, vertebral, and intracranial vessels, although it is important to note that the catheter is not advanced into these branches. This imaging technique is crucial for assessing vascular conditions and abnormalities in the thoracic aorta and its associated vessels. Upon completion of the angiography, a comprehensive written interpretation of the findings is generated, which is essential for further clinical decision-making.