CPT® Code 36227

Add-On Code

Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

The CPT® Code 36227 refers to the selective catheter placement in the external carotid artery, which is performed unilaterally. This procedure involves the insertion of a catheter into the external carotid artery, typically through a percutaneous approach via the femoral, axillary, brachial, or radial artery, with the femoral artery being the most commonly used access point. The process begins with a small incision at the site of catheter insertion, followed by the placement of an introducer sheath into the artery. A guidewire is then navigated through the arterial system, advancing from the femoral artery through the iliac arteries and into the aorta, ultimately reaching the aortic arch. The catheter is subsequently advanced over the guidewire into the aortic arch and positioned at the left common carotid or right innominate artery. Once the catheter is in place, the guidewire is manipulated into the external carotid artery, allowing for the catheter to be positioned within this artery. After the guidewire is removed, radiopaque contrast media is injected to visualize the arterial structure. Angiography is performed to assess the ipsilateral external carotid circulation, capturing images during the arterial, capillary, and venous phases as necessary. The procedure concludes with the removal of the catheter and achieving hemostasis at the arteriotomy site, either through manual pressure or other closure techniques. A written interpretation of the angiographic findings is also provided, ensuring comprehensive documentation of the procedure's outcomes.