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Official Description

Selective catheter placement, left or right pulmonary artery

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 36014 refers to the procedure of selective catheter placement in either the left or right pulmonary artery. This procedure involves the introduction of a catheter into the vascular system, specifically targeting the pulmonary arteries, which are crucial for transporting blood from the heart to the lungs for oxygenation. The process begins with the insertion of a catheter into a vein, typically the right femoral vein, although alternative sites such as the left femoral vein or an upper extremity vein may also be utilized. A small incision is made at the chosen venous access point to facilitate the placement of an introducer sheath, which allows for the safe passage of a guidewire into the venous system. Once the guidewire is in place, it is navigated through the femoral and iliac veins into the inferior vena cava and subsequently into the right atrium of the heart. A pigtail catheter, which is designed with a tip that can be deflected, is then advanced over the guidewire into the right atrium. After the guidewire is removed, the catheter can either remain in the right atrium or be further advanced into the right ventricle and then into the main pulmonary artery. The key aspect of CPT® Code 36014 is the selective catheterization of the left or right pulmonary artery, which involves precise manipulation of the catheter from the right atrium into the desired pulmonary artery. This procedure is essential for various diagnostic and therapeutic interventions, including the administration of medications or radiopaque contrast agents as needed for imaging purposes.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The selective catheter placement in the left or right pulmonary artery, as described by CPT® Code 36014, is indicated for various clinical scenarios. These may include:

  • Diagnostic Evaluation: To assess pulmonary artery conditions or abnormalities.
  • Therapeutic Interventions: For the administration of medications directly into the pulmonary arteries.
  • Imaging Procedures: To facilitate the injection of radiopaque contrast for imaging studies such as pulmonary angiography.

2. Procedure

The procedure for selective catheter placement in the left or right pulmonary artery involves several critical steps:

  • Step 1: The procedure begins with the selection of a venous access site, typically the right femoral vein, although the left femoral vein or an upper extremity vein may also be used. A small incision is made over the chosen site to allow for the insertion of an introducer sheath.
  • Step 2: An introducer sheath is placed into the vein, and a guidewire is inserted through the sheath. If the right femoral vein is selected, the guidewire is carefully maneuvered through the femoral and iliac veins, advancing it into the inferior vena cava and then into the right atrium of the heart.
  • Step 3: A pigtail catheter, which features a tip-deflecting wire, is advanced over the guidewire into the right atrium. Once the guidewire is removed, the catheter may either remain in the right atrium or be advanced further into the right ventricle and then into the main pulmonary artery.
  • Step 4: The physician then selectively manipulates the catheter into the left or right pulmonary artery, allowing for targeted interventions. This step is crucial for ensuring that the catheter is positioned correctly for the intended diagnostic or therapeutic purpose.
  • Step 5: If necessary, the catheter can be further advanced into segmental or subsegmental pulmonary arteries, which are smaller branches of the pulmonary arteries that supply specific regions of the lungs.
  • Step 6: Throughout the procedure, the physician may perform injections of medication or radiopaque contrast as needed to facilitate imaging or treatment.

3. Post-Procedure

After the selective catheter placement procedure is completed, the patient may require monitoring for any potential complications, such as bleeding or infection at the insertion site. The catheter may be left in place for a specified duration, depending on the clinical indications. Patients are typically advised on post-procedure care, which may include instructions on activity restrictions and signs of complications to watch for. Follow-up imaging or assessments may be scheduled to evaluate the effectiveness of the procedure and ensure proper recovery.

Short Descr PLACE CATHETER IN ARTERY
Medium Descr SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY
Long Descr Selective catheter placement, left or right pulmonary artery
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 2
CCS Clinical Classification 54 - Other vascular catheterization, not heart

This is a primary code that can be used with these additional add-on codes.

37252 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
37253 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
RT Right side (used to identify procedures performed on the right side of the body)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
LT Left side (used to identify procedures performed on the left side of the body)
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
GC This service has been performed in part by a resident under the direction of a teaching physician
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
99 Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
1992-01-01 Added First appearance in code book in 1992.
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