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Cerebral Angiogram

  1. Default Cerebral Angiogram
    Medical Coding Books
    Need help!! How would you code the following

    1. Right transderm cerebral angiogram selective. RCC artery, cervical view
    2. Selective RCC artery, intracranial view.
    3. Selective LCC artery, cervical view.
    4. Selective LCC artery, intracranial view.
    5. Selective right subclavian artery, cervical view
    6. Selective right vertebral artery, intracranial view
    7. Superselective catherization GDC embolization, right PICA aneurysm
    8. Control angiography selective right vertebral artery intracranial views
    times 4 runs.

    Thank you in advance

  2. #2
    would you be able to provide a complete report (access site, anatomy, etc...)

  3. Default
    The right common femoral artery ws accessed and dilated with a sheath. Catheter was navigated into the RCC with DS angiography. Catheter was removed and navigated into LCC with DS angiography performed. The catheter was removed and attempts made to navigate into the LShowever I suspect it was occluded. Catheter navigated into the RS with DS angiography. Vetebral artery selectively catherized with DS angiography performed.

    Thanks a bunch for helping me!!

  4. #4
    there was mention of a superselection and embo done in your first post but I don't see it mentioned in the piece of report on the 2nd post...

  5. #5
    Default cerebral angiogram
    Going by what I have seen in the post, I would go with this:
    36217 - rt vertebral
    36218 - rt common carotid
    36215 - lt common carotid
    75671-59 - Carotid cervical bilateral
    75680-59 - common cerebral bilateral
    75685-59 - Unilateral vertebral
    61624 - Embolization CNS permanent
    75894 - embo. s&i
    75898 x 4 - post embo. imaging

  6. #6
    36217 51 Rt vertebral/PICA
    36218 Rt common
    36215-59 51 left common
    75671 bilateral internals
    75680 bilateral commons
    75685 RT vertebral
    75894 intracranial embo
    75898 post-embo follow-up (total # could vary...I'm not sure that I would bill "4 runs" through the same artery as follow-ups. If the embo was done and the "runs" were done on the way out of the artery to check the status of the embo, I would just do that as one follow-up post embo. make sense?)

    Also, if the right PICA was superselectively cath'd, you could add 75774 for that selection.

  7. Default
    I did not include the embo because I know how to code that part. Sorry! The actual part I was questioning were the 36XXX codes of which I had picked the same codes as you - so I guess I am learning. Again thank you so much for all the support and I apologize for making it confusing.

  8. #8
    gotcha, no problem. I just wanted to make sure that I had all the info.


  9. #9
    Default Cerebral Angio
    I just went to a seminar where the presenter stated that you can code for the number of post embo. imaging that are dictated only in the brain, since it is a "delicate organ". That is why I wrote 75898 x 4. It can only be used once everywhere else.

  10. #10
    I completely agree with Jim, I've coded these forever and the interventional radiology coder by medlearn tells you that if the follow-ups are in the brain or spine (even if same artery) you may charge per follow-up. If it's in any other part of body, you would only charge it once. So I would code the 75898 x4 in this case and I agree with all the rest of Jim's codes!

    Amber, CPC

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