Ask Dr. Z

I have a question on cath charges. From a right axiliary approach, the right vertebral, right internal cartoid and left common carotid arteries were selected (with proper documentation for the S/I charges). As the most selective cath off this branch of the aorta is the right internal (36216), can you also charge 36215-59 for the right vertebral artery? I know 36218 is inappropriate, because while an additional cath, it isn't a 2nd or 3rd order cath placement. So for this exam, would 36216 and 36215-59 (x2) be correct or would we lose right vertebral cath and only charge 36216 and 36215-59? Thanks in advance for your help with this!