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Thread: Digital Subtraction Angio of Renals

  1. #1

    Default Digital Subtraction Angio of Renals

    AAPC: Back to School
    I am not sure how to code for DSA of renals.

    Procedures: R/LHC, coronaries, left ventriculogram, aortic root angiogram and digital subtraction angiogram of the renals.

    The report in summary:

    ...Swanz-Ganz catheter was advanced to the right heart, where pressures were recorded. Cardiac output was determined using the thermodilation method. A 6-French JL-4 was then advanced to the ascending aorta, cannulating the left coronary ostium where angiograms were obtained in multiple projections. This was then exchanged for a no-torque right, which was used to cannulatethe right coronary ostium where angiograms were obtained in multiple projections. This was then exchanged for a 6-French angled pigtail which was advanced to the left ventricle and withdrawn to the aortic root, where an LV-gram and aortic root angiogram were obtained. A pigtail was brought down to the abdomen where DSA of the renals was obtained.

    RHC: R atrial pressure 20. RV 16/24. PA 59/29 with mean of 42. Wedge pressure 28. Cardiac output 5.2. Cardiac index 3.1. Left ventricular end-diastolic pressure 30.

    LV-gram: revealed hyperdynamic left ventricle greater than 75% with elevated end-diastolic pressure of 30. No MR. Aortic root normal. There was about 2 to 3+ AI noted. The left ventricle was not dilated.

    Renal arteries revealed normal renals and mild disease of the infrarenal aorta.

    (Report goes on to describe findings of coronary angio)

    Here is what I have: 93460-26; 93567

    How do I code the digital subtraction angio of the renals??

    Thanks for all your help!

  2. #2
    Join Date
    Apr 2007
    Alexandria, LA


    The DSA part doesn't affect coding - it means digital subtraction angiogram. This is just a non-selective renal angiogram done at the time of a heart cath, so code G0275.

    (many years ago DSA did affect coding because it was a process done in the darkroom and so was coded separately, now DSA is just done with a flip of the switch)

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