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Cardiology Coding Alert

Correction and Additions:

Peripheral Vascular Case Study: What You Need to Know

Published on Wed Nov 05, 2003

In the October 2003 Cardiology Coding Alert, the article "Peripheral Vascular Case Study: Get a Grip on Left Heart Caths With PTAs" on page 76 stated, "Also, report 93544 for the abdominal aortogram during the catheterization."
 
The sentence should state, "Also, report 75630-26-59 (Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation; professional component; distinct procedural service) to private payers." Add to this point, "You would append modifier -59 because 75630 is bundled into the left heart cath code (93510); however, keep in mind that appending modifier -59 in this case may or may not be necessary for non-Medicare payers." 
 
Also add the paragraph, "For Medicare patients, you  would instead report G0278 (Iliac artery angiography performed at the same time of cardiac catheterization, includes catheter placement, injection of dye, radiologic supervision and interpretation and production of images  [list separately in addition to primary procedure]) for the procedure. You would not report G0275 (Renal artery angiography ...), because the documentation did not mention a nonselective renal study, the study included information on the leg arterial system, and reporting G0275 with 75724 (selective renal angiography) is an NCCI Edit violation." 
 
The article also stated that "if the physician imaged the common carotids, you would report 36215 (Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family) and +36218 (... additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family [list in addition to code for initial second or third order vessel as appropriate]) for the carotid catheterization."
 
The statement should read, "if the physician imaged the common carotids, you would report 36216-RT (Selective catheter placement ... initial second order thoracic or brachiocephalic branch; right side) for the right common carotid and 36215-LT (... left side) for the left common carotid."
 
The article further stated, "use 75680-59-26 (Angiography, carotid, cervical, bilateral, radiological supervision and interpretation; professional component) for the carotid imaging, using modifier -59 to indicate that this is a distinct procedure during the heart catheterization." The sentence should read, "use 75680-26 (Angiography, carotid, cervical, bilateral, radiological supervision and interpretation; professional component) for the carotid imaging."
 
Moreover, the article indicated that you should "code the renal studies with 36245-LT (Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family; left side). Use 36245-RT for the right renal angiogram." Add the statement, "Some carriers may require you to append modifier -50 (Bilateral procedure) to code 36245 (one line item) instead of listing the code twice with anatomical modifiers (-LT and -RT) for bilateral renal studies." 
 
Also, the article indicated that you should list modifier -59 before modifier -26 when reporting renal and leg angiography codes (75724, 75710 and 75774). The correct sequence is modifier -26, then modifier -59 (that is, 75724-26-59, 75710-26-59 and 75774-26-59).
 
Add to the end of the article, "You should also report 36247 for catheter placement in the distal leg vessels." 
 
Note: To download an updated version of the article that includes these modifications, go online to
www.codinginstitute.com.

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Cardiology Coding Alert

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