Cardiology Coding Alert

Question: A physician in our practice dictated the following: "The pigtail catheter was positioned in the suprarenal aorta, and renal aortography was performed." How should this be coded?

Ohio Subscriber  
Answer: Without knowing the details of the operative session, it is impossible to code the scenario described above with any certainty. Of particular importance is whether a left cardiac catheterization was performed. If a heart cath was performed, the catheter placement for the aortography would be coded using 93544 (injection procedure during cardiac catheterization; for aortography), but if the procedure was performed without a heart cath, 36200 (introduction of catheter, aorta) would most likely be correct, assuming the placement was nonselective.
 
Selecting the correct radiology supervision and interpretation code also depends on whether the aortography was nonselective. A nonselective placement, which is assumed here, should be coded 75625 (aortography, abdominal, by serialography, radiological supervision and interpretation).