Hello everyone! Hope I can get some help with angiography coding (and the modifier 59) here:


First scenario:

During a revascularization procedure, first a diagnostic angiography (for example CPT 75710) is performed which leads to the therapeutic procedure (for example CPT 37220). After/during angioplasty, the physician did a few more angiography to confirm that the procedure is successful, i.e. completely removal of occlusion. Should we report the angiography prior to angioplasty with modifier 59? How should we report the angiography done during/after the angioplasty? -- are they considered part of the therapeutic procedure?


Second scenario:
An anesthesiologist performs a nerve block after surgery for post-operative pain management. For example the CPT code for the nerve block is 64486 or 64488. In the CPT descriptor, both codes include "imaging guidance", so CPT 76942 should NOT be reported separately, correct? Also 64486 should be reported with modifier LT/RT and 64488 should be reported with modifier 59 as they are performed for post-op pain management, is this appropriate?


In the case of CPT 64447, we will be reporting it along with CPT 76942, it that the case?