selective catheter placement

Can someone explain the definition of "order" when coding arterial catheter placement within a vascular family. One of my docs is inserting a multi port lytic drip catheter through the inferior portion of the abdominal aorta to the tibial artery, using fluoroscopic guidance and power injector to diagnose and treat overnight with lytics. Can anyone help me code such a procedure?

selective catheter placement

The CPT book has vascular families and the branch order in Appendix L. CPT makes the assumption that the starting point is catheterization of the aorta-like your example so the tibial artery is a "beyond third order" the catheterization of the tibal from the AA is 36247. Your example doesn't give enough information to code a diagnostic angiogram of the lower extremity, 75710 (26).

The transcather lysis is additionally coded with 37201 and 75896.

Usually after a period of time a follow-up angiogram is documented to check progress of the lysis procedure-75898.

The key to coding arterial catheter placement is identifying the starting point and then the final catheter placement for the study.
Hope this helps.
Louise

thanks

thank you so much for the insight. I have been auditing E&M services and coding ortho and chemo for awhile so this is new for me.