CPT® Code 36225

Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed

The CPT® Code 36225 refers to a specific medical procedure known as selective catheter placement in the subclavian or innominate artery, performed unilaterally. This procedure involves the precise placement of a catheter into either the right innominate (brachiocephalic) artery or the left subclavian artery, allowing for detailed imaging of the blood vessels in the neck and brain region. The procedure is typically conducted using a percutaneous approach, which means that the catheter is inserted through the skin into the artery, often utilizing access points such as the femoral, axillary, brachial, or radial arteries. The most common method involves a retrograde approach through the femoral artery. During the procedure, a small incision is made at the site of catheter insertion, and an introducer sheath is placed into the artery to facilitate the passage of a guidewire. The guidewire is then navigated through the arterial system, advancing through the femoral and iliac arteries into the aorta, and subsequently into the aortic arch. The catheter is carefully maneuvered over the guidewire to reach the designated artery, either the left subclavian or the right innominate artery, without advancing into the vertebral artery. Once the catheter is positioned correctly, radiopaque contrast media is injected to visualize the blood vessels, allowing for angiography of the ipsilateral vertebral circulation. This imaging may also include the cervicocerebral arch if performed. The procedure encompasses all necessary radiological supervision and interpretation, ensuring that the findings are documented comprehensively. After the imaging is completed, the catheter is removed, and hemostasis is achieved at the insertion site, concluding the procedure with a written interpretation of the results provided for further analysis and record-keeping.