Ask Dr. Z

Patient was being treated for a GBM.  After completion of cerebral angiogram, a guide catheter and a Terumo guidewire were used to selectively catheterize the distal LICA.  A roadmap technique demonstrated best view of the feeding pedicle.  Once this was achieved, a microcatheter and Precision Microwire were used to selectively catheterize the distal M2 segment.  Superselective angiogram revealed a discrete tumor blush. Once this was achieved, 35 mg of mannitol, after being filtered, was slowly injected.  This was followed by a total dose of 400 mg dosing selectively injected into the distal MCA.  He does say that this is an off-label non-FDA approved and compassionate use procedure.  The only codes I can see to use are either 37202 or 37211, but neither seems to fit.  And would I assign code 36228 for the superselective angio of the M2 segment even though done by roadmap technique?