CPT® Code 36252

Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral

A selective catheter placement in the main renal artery and any accessory renal arteries is a specialized procedure performed for renal angiography. This procedure involves the introduction of a catheter into the renal arteries to visualize the blood vessels supplying the kidneys. The process typically begins with the insertion of a catheter into an extremity artery, most commonly the femoral artery located in the groin area. A small incision is made at the insertion site to facilitate access to the artery. An introducer sheath is then placed within the artery, followed by the insertion of a guidewire. If the right femoral artery is selected for access, the guidewire is carefully navigated through the femoral and iliac arteries, advancing into the aorta under fluoroscopic guidance, which allows for real-time imaging during the procedure. Once the guidewire is positioned correctly, a catheter is advanced over it into the aorta. The guidewire is subsequently maneuvered into the main renal artery and any accessory renal arteries. The physician skillfully manipulates the catheter over the guidewire until it reaches the desired location within the renal arteries. After the guidewire is removed, the physician may inject medication or radiopaque contrast media to enhance the visibility of the renal arteries during imaging. Additionally, pressure gradient measurements may be taken to assess any narrowing in the renal arteries that could impact blood flow to the kidneys. The procedure includes obtaining images, processing them, and making permanent recordings as necessary. Finally, the physician reviews the captured images and recordings, providing a comprehensive written report of the findings. For coding purposes, it is important to note that CPT® Code 36251 is used for a selective unilateral renal angiogram, while CPT® Code 36252 is designated for a selective bilateral study.