CPT® Code 36248

Add-On Code

Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate)

A selective catheter placement procedure involves the introduction of a catheter into a specific branch of the arterial system, particularly within the abdominal, pelvic, or lower extremity regions. This procedure is categorized under the CPT® code 36248, which specifically refers to the placement of a catheter into additional second order, third order, or higher branches of arteries within a vascular family. The process typically begins with the insertion of a catheter into an extremity artery, most commonly through the femoral artery, although access may also be obtained via an upper extremity artery. A small incision is made at the insertion site to facilitate the placement of an introducer sheath, which allows for the safe passage of a guidewire into the arterial system. Once the guidewire is in place, it is navigated through the femoral and iliac arteries and into the aorta. The catheter is then advanced over the guidewire into the aorta, and the physician continues to manipulate the catheter through the arterial branches, selectively advancing it into first order, second order, third order, and beyond branches as necessary. The goal is to position the catheter in the highest order branch that requires evaluation. After the catheter is correctly placed, the guidewire is removed, and the physician may perform an injection of medication or radiopaque contrast media to visualize the vascular structures. This procedure is essential for diagnostic and therapeutic interventions within the vascular system, allowing for detailed examination and treatment of various conditions affecting the arteries in these regions.