Cerebral Carotid Angiography

schuchmanb

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Is it appropriate to code the S&I for bilateral cerebral carotids (75671) when only one side is injected but both hemispheres are visualized due to collateralization/overflow/reflux? (One specific exam I have states "intracranial circulation on the left collateralizes to the right hemisphere via a patent anterior communicating".) I know you don't need a selective cath placement to use the cerebral carotid codes, but I thought I had heard you can't code them from the reflux, but I can't seem to find that in writing anywhere.

Any help and/or where to find the answer to this would be greatly appreciated.

Thank you,
Barbara
 

dhuston

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It's been said in RBMA seminars that you could code the contralateral vertebral angiogram from reflux but I've never heard the question asked of the carotid arteries. Personally I would not code for it. Part of the internal carotid artery is cerebral and I doubt if the contrast refluxed all the way down to that point so you wouldn't have a complete exam.

Diane Huston, CPC, RCC
 
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