© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 36100 refers to the procedure involving the introduction of a needle or intracatheter into either the carotid or vertebral artery. This procedure is essential for various diagnostic and therapeutic interventions. In the case of accessing the carotid artery, the clinician first locates the artery through palpation, ensuring proper stabilization between the index and middle fingers. The needle or intracatheter is then introduced through the skin and carefully advanced toward the artery until it makes contact with the artery wall, at which point the artery is punctured. It is crucial to advance the needle or intracatheter in a cephalad direction while taking care to avoid any injury to the intima, which is the inner lining of the carotid artery. For the vertebral artery, the approach is lateral, and the needle or intracatheter is advanced through one of the cervical interspaces. The clinician compresses the skin of the neck against the cervical spine using the index and middle fingers before puncturing the skin. The needle or intracatheter is then advanced until it reaches the intervertebral foramina at the anterior tubercle of the transverse process, allowing for access into the vertebral artery. To confirm proper placement, blood is aspirated from the needle or intracatheter. This procedure may also involve the injection of medication or radiopaque contrast media as necessary, facilitating further diagnostic imaging or treatment interventions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 36100 is indicated for various clinical scenarios where access to the carotid or vertebral artery is necessary. The following conditions may warrant this procedure:
The procedure for the introduction of a needle or intracatheter into the carotid or vertebral artery involves several critical steps, each requiring precision and care:
After the procedure, appropriate post-procedure care is essential to ensure patient safety and monitor for any potential complications. Patients should be observed for signs of bleeding at the puncture site, as well as for any neurological deficits that may indicate complications related to arterial access. Follow-up imaging may be required to assess the success of the procedure and to ensure that there are no adverse effects. Additionally, instructions regarding activity restrictions and signs of complications should be provided to the patient to ensure proper recovery.
| Short Descr | ESTABLISH ACCESS TO ARTERY | Medium Descr | INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY | Long Descr | Introduction of needle or intracatheter, carotid or vertebral 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) | I4B - Imaging/procedure - 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 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). | 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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