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Cardiac Catheterization with Femoral Angiography

  1. #1
    Default Cardiac Catheterization with Femoral Angiography
    Medical Coding Books
    When is it appropriate or what type of indication is necessary in order to code
    75710/75716 versus 75630? If I'm understanding this correctly, 76530 is when a descending aortogram is performed from 1 catheter position within the aorta with a lower extremity runoff, but if that's the case, then what indications do I need in order to use 75716?

  2. Default
    Cath in abd with one angiography of the aorta with the run-off into both legs. So one angio injection---code 75630

    Cath in the abd with an angiograpy. Then cath moved to lower abd with a run-off angiography of both legs. So 2 angio injections---code 75625 and 75716

    If an additional selective angiography is done of one of the legs---code 75774. Code it twice with -59 if additional selective is done of both legs. Also always code the 362xx code for each selective cath placement

    I found this link that provides some good info...........

    75630 Versus 75625/75716

    According to C.J. Wolf, MD, CPC, CPC-H, senior consultant at Intermountain Health Care in Salt Lake City, CPT code 75630 should be reported when the abdominal aorta and the lower extremities iliofemoral studies are studied via a single catheter position and single contrast injection. Generally, the way the procedure works is that the physician will insert the catheter and advance it into the proximal aorta; at that point, he will inject the contrast and obtain radiographic images that will later be interpreted. This study provides information about the distal abdominal aorta and the lower extremity arteries in an examination commonly referred to as a “run-off” angiogram (e.g., an examination in which the contrast outlines the run-off arteries of the lower abdominal aorta). The key to this procedure, Wolf says, is that it is performed via a single catheter position without regard to the number of contrast injections.

    In addition, 75630 is used to describe a focused angiogram that is restricted to studying the abdominal aorta, the pelvic vessels, and the proximal lower extremity arteries as is often performed in patients with abdominal aortic aneurysms without symptoms of claudication or lower extremity ischemia and normal noninvasive vascular tests.

    Coding scenarios may get more complicated, Wolf says, if, as frequently occurs after positioning the catheter in the proximal aorta, the physician brings it back to the bifurcation of the abdominal aorta i.e., where the aorta splits into the common iliacs. The physician may then reposition the catheter and inject contrast again to examine the lower extremities thoroughly.

    Report 75625 and 75716 together only when a full and complete abdominal aortogram is followed by a full and complete bilateral lower extremity study one that includes iliofemoral and lower extremity arteries. “The key words here are ‘full and complete,' ” Wolf says, because the run-off dye from a simple 75630 aortography will provide some opportunity to view the lower extremities.

    The two critical elements to justify reporting both 75625 and 75716 are:

    the necessity of repositioning the catheter within the aorta between the performance of the complete aortogram and the lower extremity angiogram

    the performance of a complete bilateral lower extremity angiogram to the extent allowed by the patient's underlying anatomy and physiology and using a nonselective catheter position.

    If selective catheterization is necessary to allow complete visualization of the vessels into the patient's feet, then further surgical and RS&I codes may be indicated as well.
    Last edited by sbicknell; 05-26-2010 at 12:09 PM.

  3. #3
    Thank you very much for your help. I think I finally understand the difference!!

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