Cardiology Coding Alert

Question: Can you clarify when to use G0278 instead of 75710 alongside a cardiac cath?

Maryland Subscriber

Answer: Let’s break the code descriptor for G0278 down into its component parts to understand which services it applies to:

• Iliac and/or femoral artery angiography
• Non-selective
• Bilateral or ipsilateral to catheter insertion
• Performed at the same time as cardiac catheterization and/or coronary angiography
• Includes:
  • Positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery
  • Injection of dye
  • Production of permanent images, and
  • Radiologic supervision and interpretation
• List separately in addition to primary procedure.

Medicare accepts G0278, but you should confirm whether other payers accept it.

75710: The other code you mention is 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation).

To report extremity angiography at the same session as a cardiac catheterization, you would use 75710 if the physician performed a selective contralateral extremity study (meaning selective catheter placement on the contralateral, or opposite, side) without performing a nonselective study of both sides (G0278) prior to the selective study.

+75774 tip: If the physician performed a bilateral nonselective study (G0278) followed by a contralateral, selective study for a better view, then you would report +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation [List separately in addition to code for primary procedure]) in addition to G0278. You would also need to report the appropriate selective catheter placement code. It’s uncommon to report G0278 and +75774 together, though.