Radiology Coding Alert

READER QUESTIONS:

Don't Overlook Angiography Add-On Code

Question: When may I report 75774?


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Answer: In short, you may report +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation) when the provider performs an additional selective angiography study within the same anatomic area as the initial vessel studied.

Because 75774 is an add-on code, you must report it alongside the code for the initial angiography.

Watch for: The descriptor specifies that this additional study must be selective. One of two things must happen to graduate from being a non-selective catheterization to one that is selective:

1. the provider could manipulate the catheter through a fork in the arterial pathway while moving away from the aorta, or

2. after entering the aorta, the provider could manipulate the catheter into a vascular family that is different from the one initially accessed. 

Code 75774 example: A study requires imaging of the bilateral lower extremities (75716, Angiography, extremity, bilateral, radiological supervision and interpretation) from a catheter position in the lowest portion of the abdominal aorta. This study reveals an abnormal flow pattern in the contralateral leg at the knee level.

To more definitively clarify the defect, the doctor selectively catheterizes the contralateral superficial femoral artery (36247, Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family) and performs another study of the contralateral leg. Report the additional contralateral leg study with 75774.

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