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Thread: Cerebral Arteriogram

  1. #1
    Join Date
    Apr 2007
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    Default Cerebral Arteriogram

    Hi Everyone,

    I coded a patient for a cerebral arteriogram who had a meningioma. The exam was for blood flow to the tumor which consisted of Bilateral Common Carotids, Bilateral Internal Carotids, Bilateral External Carotids, and Bilateral Vertebrals. Ten days later, the patient has a embolization of the vessels feeding the tumor. The doctor again selects Bilateral Internal Carotids, Bilateral External Carotids, Bilateral Vertebrals with angiography. He then selects a branch of the right vertebral, extracrainial, and performs embolization on the meningioma. My question/ confirmation is that I do not bill for the second diagnostic angio, since the patient had a previous angio (10 days earlier), and code just for the embolization. Where can I get documentation (I'm blanking out on this) for not billing the second diagnostic angio in case I asked for the documentation?

    Thanks,
    Jim Pawloski, CIRCC, R.T. (CV)

  2. #2
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    Apr 2007
    Location
    Birmingham, Alabama
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    Default

    Quote Originally Posted by Jim Pawloski View Post
    Hi Everyone,

    I coded a patient for a cerebral arteriogram who had a meningioma. The exam was for blood flow to the tumor which consisted of Bilateral Common Carotids, Bilateral Internal Carotids, Bilateral External Carotids, and Bilateral Vertebrals. Ten days later, the patient has a embolization of the vessels feeding the tumor. The doctor again selects Bilateral Internal Carotids, Bilateral External Carotids, Bilateral Vertebrals with angiography. He then selects a branch of the right vertebral, extracrainial, and performs embolization on the meningioma. My question/ confirmation is that I do not bill for the second diagnostic angio, since the patient had a previous angio (10 days earlier), and code just for the embolization. Where can I get documentation (I'm blanking out on this) for not billing the second diagnostic angio in case I asked for the documentation?

    Thanks,
    Jim Pawloski, CIRCC, R.T. (CV)
    Hi Jim,
    Look in the CPT book, in the Vascular Procedures heading (before CPT 75600 in my book). Under the Heading Aorta and Arteries it states:"Diagnostic angiography (RS&I) codes should NOT be used with interventional procedures for": and goes on to list contrast injections, angiography, roadmapping etc. Maybe this will help.

    Be advised, this in unpopular

    HTH
    Danny L. Peoples
    CIRCC,CPC

  3. #3
    Join Date
    Apr 2007
    Location
    Ann Arbor
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    997

    Default

    2017 ICD-10-CM Coding Book
    Quote Originally Posted by dpeoples View Post
    Hi Jim,
    Look in the CPT book, in the Vascular Procedures heading (before CPT 75600 in my book). Under the Heading Aorta and Arteries it states:"Diagnostic angiography (RS&I) codes should NOT be used with interventional procedures for": and goes on to list contrast injections, angiography, roadmapping etc. Maybe this will help.

    Be advised, this in unpopular

    HTH
    Thank you very much for your quick response.

    Jim Pawloski, CIRCC

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