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The CPT® Code 36160 refers to the introduction of a needle or intracatheter into the aorta via a translumbar approach. This procedure is characterized by its infrequent use in clinical practice. During the procedure, the patient is positioned prone, which means they lie flat on their stomach. A long hollow needle, which is encased in a protective sheath, is carefully advanced into the aorta through the left flank. This approach allows for direct access to the aorta, facilitating the introduction of medications or radiopaque contrast media as necessary. After the needle is inserted, it is withdrawn, leaving the sheath in place to maintain access to the aorta. Following the injection, the sheath is subsequently removed. To manage any potential external bleeding, the patient is then repositioned to a supine position, with a bed of gauze placed under the left flank. Throughout the procedure, the patient is closely monitored for signs of internal hemorrhage, ensuring prompt intervention if complications arise. This detailed description highlights the technical aspects and procedural context of the translumbar approach to aortic access.
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The indications for the CPT® Code 36160 procedure include the need for direct access to the aorta for various medical interventions. This may involve the administration of medications or the injection of radiopaque contrast media for diagnostic imaging purposes. The translumbar approach is typically considered in specific clinical scenarios where other access routes may not be feasible or when a direct approach to the aorta is required.
The procedure begins with the patient being placed in a prone position, ensuring optimal access to the aorta through the left flank. A long hollow needle, which is contained within a protective sheath, is then carefully advanced into the aorta. This step requires precision to ensure that the needle reaches the target site without causing unnecessary trauma to surrounding tissues. Once the needle is properly positioned within the aorta, it is withdrawn, leaving the sheath in place. This allows for continued access to the aorta for subsequent interventions. Following the needle withdrawal, the healthcare provider may perform an injection of medication or radiopaque contrast media as needed, depending on the clinical objectives of the procedure. After the injection is completed, the sheath is removed to conclude the access phase. To manage any potential external bleeding that may occur at the access site, the patient is then repositioned to a supine position, with a bed of gauze placed underneath the left flank. This gauze serves to absorb any blood and control bleeding. Throughout the entire procedure, the patient is closely monitored for any signs of internal hemorrhage, which is critical for ensuring patient safety and prompt management of any complications that may arise.
After the completion of the procedure, the patient requires careful monitoring to assess for any complications, particularly internal bleeding. The gauze placed under the left flank is essential for managing any external bleeding that may occur at the access site. Healthcare providers should observe the patient for signs of hemorrhage, such as changes in vital signs or any unusual symptoms. Depending on the patient's condition and the specifics of the procedure, further imaging or interventions may be necessary to ensure that the aorta remains stable and that no complications have developed. The overall recovery process will vary based on the individual patient's health status and the complexity of the procedure performed.
| Short Descr | ESTABLISH ACCESS TO AORTA | Medium Descr | INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR | Long Descr | Introduction of needle or intracatheter, aortic, translumbar | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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). | 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. | 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). | 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. | 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) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | 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 | 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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