Radiology Coding Alert

Question: I've tried to report a bilateral selective renal arteriogram a couple of ways, but keep getting denials. The first time I reported CPT 36245 , 75724 and 75625. The second time I changed the 75625 to G0275, but still no luck. What am I doing wrong?


South Carolina Subscriber Answer: Remove 75625 (Aortography, abdominal, by serialography, radiological supervision and interpretation) and G0275 (Renal artery angiography [unilateral or bilateral] performed at the time of cardiac catheterization, includes catheter placement, injection of dye, flush aortogram and radiologic supervision and interpretation and production of images [list separately in addition to primary procedure]) from your claim and you should finally get the reimbursement you deserve.

What to do: If your interventional radiologist performs a bilateral selective renal arteriogram, you should report 36245 (Selective catheter placement,
arterial system; each first-order abdominal, pelvic, or lower-extremity artery branch, within a vascular family) twice and 75724-26 (Angiography, renal, bilateral, selective [including flush aortogram], radiological supervision and interpretation; professional component). The selective renal exam includes the arteriogram.

Caution: Payers differ on which modifiers you need for bilateral renal artery catheter placement claims. You may want to apply modifiers LT (Left side) and RT (Right side) to each 36245 code or even 59 (Distinct procedural service), depending on your payer.

Watch out: Don't report G0275 unless your physician performs a nonselective renal arteriogram during the same encounter as a cardiac catheterization.

The unilateral and bilateral renal arteriography includes the "flush" aortogram, so don't code the non-selective study separately.