Summary & Overview
CPT 36248: Selective Additional Arterial Branch Angiography
CPT code 36248 represents selective placement of a catheter into an additional second-order, third-order, or more distal abdominal, pelvic, or lower extremity arterial branch during angiography. This code captures the additional technical and procedural work required when operators selectively catheterize deeper arterial branches beyond an initial targeted vessel. Nationally, angiographic procedures coded with 36248 are relevant for vascular diagnostic workflows and for planning or delivering endovascular therapies in peripheral and visceral arterial territories.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for selective arterial branch catheterization, typical sites of service, and the common modifiers that may accompany procedural reporting. The publication also outlines benchmarking areas such as utilization patterns, relative value considerations, and reimbursement policy topics that affect coverage and coding practice.
This analysis provides clinicians, billing staff, and policy stakeholders with an understanding of when CPT code 36248 is used, why it matters for procedural documentation and billing, and what areas of policy and payer guidance to monitor. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 36248 describes a selective angiographic catheter placement into an additional second-order, third-order, or more distal branch of an abdominal, pelvic, or lower extremity artery within the same vascular family. Angiography uses a radiopaque contrast agent to visualize blood vessels under X-ray to assist in diagnosis and endovascular treatment planning.
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Service type: Diagnostic and interventional vascular angiography procedure
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Typical site of service: Hospital outpatient department, ambulatory surgical center, or interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of peripheral arterial disease presents with worsening right lower-extremity claudication and decreased ankle-brachial index. Noninvasive testing (duplex ultrasound and ABI) suggests focal arterial stenosis in a distal tibial branch. The vascular interventional team schedules a diagnostic and possible therapeutic angiographic procedure to selectively catheterize the offending branch to define lesion anatomy and permit adjunctive treatment (angioplasty or embolization) if indicated.
The patient is admitted to an outpatient interventional radiology or vascular surgery suite. Conscious sedation or monitored anesthesia care may be provided depending on comorbidities and complexity. Vascular access (commonly common femoral artery) is obtained, and guide catheters/wires are advanced to the targeted vascular family. Selective catheterization of an additional second-order, third-order, or more distal branch of an abdominal, pelvic, or lower-extremity artery is performed using fluoroscopic guidance and radiopaque contrast to visualize the vessel. Images are documented, contrast volume and fluoroscopy time recorded, and if therapeutic intervention is required (angioplasty, stent, or embolization), appropriate additional codes are reported. Post-procedure recovery includes hemostasis, access site monitoring, and discharge instructions or hospital admission if complications occur.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service |