Professionals involved in coding interventional radiology procedures will want to review the latest guidance published in the July 2026 CPT® Assistant, titled Coding Brief: Reporting Selective Arterial Catheter Placement (36248). Because CPT® Assistant is published by the American Medical Association (AMA), many organizations rely on its guidance to support CPT® code assignment and reporting.

Key Points from the Coding Brief

According to the July 2026 CPT® Assistant, the AMA provides the following reporting guidance:

• Additional second- and/or third-order arterial catheterizations within the same family of arteries supplied by a single first-order abdominal artery should be reported with one unit of +36248.
• A similar reporting rationale applies to +36218 for thoracic arterial catheterization.
• Once a third-order vessel has been selectively catheterized and reported, any further advancement into branches arising from that third-order vessel is considered part of the same vascular family and is included in the reported service.
• Code +36248 should be reported only for named vessels, not for branches arising from those vessels.

To illustrate this guidance, the Coding Brief presents an example in which the physician selectively catheterizes the gastroduodenal artery (GDA) and two branches arising from the right hepatic artery. In this scenario, the AMA instructs coders to report 36247 and one unit of +36248, explaining that additional catheterization of branches arising from the reported third-order vessel is not separately reportable.

Organizational Considerations

Organizations may wish to review their current selective arterial catheterization coding practices in light of the July 2026 CPT® Assistant guidance. Consider:

• Reviewing internal coding policies, education materials, and decision trees related to selective arterial catheterization.
• Evaluating whether coding software, claim scrubbers, internal coding edits, and revenue integrity workflows align with the July 2026 CPT® Assistant guidance.
• Educating coding professionals, auditors, physicians, and clinical documentation staff on the published AMA guidance.
• Assessing whether internal audit methodologies and compliance reviews should be updated to reflect the published guidance.
• Monitoring CMS and commercial payers for additional guidance or policy updates regarding selective arterial catheterization reporting.

Considerations for Coders

• Reviewing vascular family anatomy before assigning selective arterial catheterization codes.
• Distinguishing between named vessels and unnamed branches, as +36248 is reported only for named vessels.
• Identifying the highest-order selectively catheterized named vessel within each vascular family.
• Recognizing that, according to the July 2026 CPT® Assistant, additional advancement into branches arising from a reported third-order vessel is included in the reported service.
• Reviewing internal policies or discussing questions with coding leadership or compliance staff, particularly if current practices differ from the published AMA guidance.

Considerations for Auditors

• Reviewing claims that report multiple units of +36218 or +36248 within a single vascular family.
• Verifying that documentation supports the reported vascular order, vascular family, and named vessel selection.
• Updating audit tools, educational resources, and internal review criteria to reflect the July 2026 CPT® Assistant guidance.
• Monitoring payer communications, recognizing that payer policies may not immediately reflect newly published AMA guidance.

Final Thoughts

Although the CPT® code descriptors and CPT® guidelines for +36218 and +36248 remain unchanged, the July 2026 CPT® Assistant provides additional reporting guidance regarding the application of these codes when multiple vessels within the same vascular family are selectively catheterized. Organizations, coding professionals, and auditors should review the published guidance and evaluate whether existing coding policies, educational materials, and audit practices align with the AMA’s published reporting guidance while continuing to monitor CMS and commercial payer guidance.