CPT® Code 36253

Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, 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; unilateral

A super-selective catheter placement involves the precise positioning of a catheter into one or more second order or higher branches of the renal artery for the purpose of conducting renal angiography. This procedure begins with the introduction of a catheter into an artery, typically the femoral artery located in the groin, through a small incision made at the insertion site. The catheter is guided through the vascular system under fluoroscopic imaging, allowing the physician to visualize the path as it navigates through the femoral and iliac arteries into the aorta. Once in the aorta, the catheter is advanced into the main renal artery and further into its higher order branches, which may include second, third, or even higher order branches, depending on the specific areas that require evaluation. During the procedure, the physician may perform pressure gradient measurements to assess any narrowing in the renal arteries that could impact blood flow to the kidneys. The use of radiopaque contrast media is essential for enhancing the visibility of the renal arteries during imaging. After the necessary images are captured, they are processed and recorded permanently for further analysis. The physician then reviews these images and prepares a comprehensive report detailing the findings of the angiography. This procedure is specifically coded as CPT® Code 36253 for unilateral renal angiography, while a bilateral study is coded as CPT® Code 36254.