Summary & Overview
CPT 36252: Bilateral Selective Renal Angiography
CPT code 36252 represents bilateral selective renal angiography: a catheter-based diagnostic procedure in which contrast is injected into the main renal arteries via arterial access at the groin to visualize renal vasculature. This imaging procedure is clinically important for diagnosing renal artery stenosis, occlusion, or thromboembolic disease and often guides subsequent interventional or medical management. Nationally, renal angiography is a standard diagnostic tool in vascular and nephrology practice and is billed across hospital outpatient departments and ambulatory surgery centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise reference for billing and coverage context, including typical sites of service, common billing modifiers (listed separately), and where to look for clinical and coding guidance.
Readers will find a summary of the clinical context for CPT code 36252, its primary service setting, and payor coverage landscape. The piece highlights benchmarking and policy-relevant considerations for national stakeholders, and points to areas where payor policies or prior authorization rules commonly apply. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 36252 describes bilateral selective renal angiography performed by inserting a catheter via an arterial access at the groin (femoral artery), navigating to the main renal arteries, and injecting contrast dye to visualize the renal vasculature under X‑ray. The procedure is used to investigate blockages, stenosis, or thrombus in the renal blood vessels.
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Service type: Diagnostic vascular imaging / catheter-based diagnostic angiography of the renal arteries
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Typical site of service: Hospital outpatient department or ambulatory surgical center with catheterization laboratory capabilities
Clinical & Coding Specifications
Clinical Context
A 64-year-old hypertensive male with chronic kidney disease and worsening flank pain and new-onset hypertension undergoes diagnostic renal arteriography. The interventional radiologist or vascular surgeon obtains femoral arterial access, advances a catheter into the ipsilateral renal artery, and injects iodinated contrast under fluoroscopy to visualize the main renal artery and first-order branches. The procedure is repeated contralaterally during the same session to evaluate bilateral renal artery stenosis suspected to be causing secondary hypertension and renal dysfunction. Typical workflow includes pre-procedure consent, review of renal function and allergy history, arterial puncture in the groin (common femoral artery), catheter manipulation to renal ostia, selective contrast injections with real-time imaging, image documentation, catheter removal, hemostasis (manual compression or closure device), post-procedure monitoring for bleeding, distal pulses, and renal function checks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When both left and right renal arteriography are performed during the same session (modifier applied to indicate bilateral service when appropriate billing rules allow). |
59 |