Cardiology Coding Alert

Question: What code do I use to bill for a transluminal balloon angioplasty of the carotid artery?

Patricia Rosbrook, Account Manager
Cardiac Arrhythmia Associates, San Diego

Answer: Transluminal balloon angioplasty of the carotid artery is considered a high-risk procedure because the carotid artery delivers blood to the brain. When this procedure is performed, it should be coded 35475 (transluminal balloon angioplasty, brachiocephalic trunk or branches, each vessel), says Susan Callaway-Stradley, CPC, CCS-P, an independent coding consultant and educator based in North Augusta, S.C. This is considered appropriate for left carotid and right carotid angioplasties, even though the left carotid arises directly off the aorta.

If the cardiologist performs radiological supervision and interpretation, 75962 (transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation) should also be coded, with modifier -26 (professional component) appended. But many carriers will not pay for the 75962 when it is performed on a carotid artery. Other carriers, meanwhile, do not require that modifier -26 be appended to the supervision and interpretation. And yet still other carriers will not cover carotid angioplasties at all. Callaway-Stradley recommends that you contact your carrier to find out its specific requirements.