Need help please

jperkins

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During coronary angiography and stent placement, the left circumflex artery was visualized via injection of the left subclavian artery. Is the subclavian injection bundled to the angio code or is it coded separately? Would it be 75685 unilateral veterbral, 75710 upper extremity, or something completely different. All help appreciated.
 

Jim Pawloski

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During coronary angiography and stent placement, the left circumflex artery was visualized via injection of the left subclavian artery. Is the subclavian injection bundled to the angio code or is it coded separately? Would it be 75685 unilateral veterbral, 75710 upper extremity, or something completely different. All help appreciated.
The patient had to had a bypass graft (LIMA) to the Circumflex to be able to see that artery, I'm assuming. If so, you bill for Coronary Angio. w/ grafts. The stent is an add-on code.
HTH,
Jim Pawloski, CIRCC
 

jewlz0879

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During coronary angiography and stent placement, the left circumflex artery was visualized via injection of the left subclavian artery. Is the subclavian injection bundled to the angio code or is it coded separately? Would it be 75685 unilateral veterbral, 75710 upper extremity, or something completely different. All help appreciated.
I don't think I would seperately bill for it since he was visualizing the LC by means of the Subclavian and not assessing the subclavian itself. I not use 75685 as this is the S&I for a vertebral artery and not the subclavian. I also would not use 75710 because the subclavian artery arises from the Aortic root.

I've never had anything like this before so if anyone else has and I'm wrong, I'm always open to learning more and expanding my coding knowledge!
 

Jim Pawloski

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I don't think I would seperately bill for it since he was visualizing the LC by means of the Subclavian and not assessing the subclavian itself. I not use 75685 as this is the S&I for a vertebral artery and not the subclavian. I also would not use 75710 because the subclavian artery arises from the Aortic root.

I've never had anything like this before so if anyone else has and I'm wrong, I'm always open to learning more and expanding my coding knowledge!
Assuming normal anatomy, the subclavian artery on the right comes off the innomiate artery, the left subclavian come off the aortic arch after the innominate artery and lt carotid arteries. The left vertebral artery comes off the lt subclavian artery. The IMA's come off the subclavian arteries. So we need a lot more information because I cannot see anything like this happening.

Jim Pawloski, CIRCC, R.T.(R)(CV)
 
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