Wiki Cardiology Peripheral Coding

[Regina Tinney]

New to peripheral coding, need opinion for following procedures, this is a brief synopsis...thanks!.....Gina

Distal abdominal aortogram at the level of the renal arteries with bilateral peripheral runoff...Selective arteriogram of right lower extremity using contralateral approach...Selective arteriogram of left lower extremity.

Access obtained via left common femoral artery, cath placed into aorta at level of renal arteries and abdominal aortogram with bilateral runoff was performed....Selective arteriogram of the right lower extremity was perfoirmed using gliding catheter and the contralateral approach, the tip of the catheter was in the distal portion of the right SFA....Selective arteriogram of the left lower extremity was performed with injection through the left common femoral artery sheath.

36247, 36246-59, 75630 or 75716-26, 75774-26

 

[Regina Tinney]

need help asap

 

[Jim Pawloski]

New to peripheral coding, need opinion for following procedures, this is a brief synopsis...thanks!.....Gina

Distal abdominal aortogram at the level of the renal arteries with bilateral peripheral runoff...Selective arteriogram of right lower extremity using contralateral approach...Selective arteriogram of left lower extremity.

Access obtained via left common femoral artery, cath placed into aorta at level of renal arteries and abdominal aortogram with bilateral runoff was performed....Selective arteriogram of the right lower extremity was perfoirmed using gliding catheter and the contralateral approach, the tip of the catheter was in the distal portion of the right SFA....Selective arteriogram of the left lower extremity was performed with injection through the left common femoral artery sheath.

36247, 36246-59, 75630 or 75716-26, 75774-26

Since the catheter went into the rt sfa, you can only bill the 36247. You have to code where the catheter to the highest order. 36246-59 cannot be billed. I would not bill the 75774-26 because there is not documentation of a separate catheter position for the additional angio. Would need more information.

I hope this helps you out.
Jim Pawloski

 

[psedgley]

I agree that you would only code one cath placement, the furthest, which would be 36247. You would code the Aortogram 75625, and 75716 for the bilateral peripheral angio separately and not the 75630. 75630 is usually the correct code if one injection is done in the aorta and the md looks at the aorta and the proximal iliacs...it is considered one study. But in this case he moved the catheter to the contralateral side for a selective injection and also injected the left leg through the sheath. 75774 would not be appropriate, at least with the documentation you gave. The md would also have to document findings related to the aorta and both legs.