# CPT 75827 along with 77001



## muralimohan_p (May 20, 2009)

Hi All,

Can anyone help me out for the below mentioned scenario, 

Informed consent was obtained by appropriate protocol with vocalization of understanding and questions answered. Examination performed with strict attention to asepsis, with local anesthesia. No complications.

Direct ultrasound visualized micropuncture access with image saved and documentation, right internal jugular vein. The guidewire does not traverse into the superior vena cava. Superior vena cavogram was performed demonstrating a high-grade stenosis of the innominate vein, which was traverse fluoroscopically. Non-tunneled dialysis catheter was placed with excellent function verified. The catheter secured and dressed.

IMPRESSION
NON-TUNNELED DIALYSIS CATHETER READY FOR USE. HIGH-GRADE STENOSIS, RIGHT INNOMINATE VEIN.


My question is 
Do we need to code for SVC gram along with fluoroscopy code?

Thanks in advance


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## xylinam (May 20, 2009)

*Re use of flouroscopy with 75827*

The 77001 is included in the 75827.  In my Ingenix CPT Expert, under the 75801-75893 is states under the _INCLUDES_ caption, it states _flouroscopic guidance for intervention_.    Have a great day and i hope that helped.


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## luz.buenaventura (May 20, 2009)

radiologic supervision and interpretation codes for specific procedures, like 75827, include all the radiologic services necessary for that procedure. Do not additionally report fluoroscopy or ultrasound guidance.


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## Joe_coder07 (May 21, 2009)

i think 77001 is not included in 75827, we can bill both these codes by adding mod 59 to 75827. only ultrasound guidance is included in 75827, that too can billed seperately appending approp modifier.


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## Shirleybala (May 21, 2009)

In these type of cases i am using only 75827


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## dhuston (May 21, 2009)

The 77001 is for final positioning of the catheter with imaging documentation which doesn't seem to be well documented in this example.  I don't think you should code fluoro in this case which then leaves you open to code the 75827.

Otherwise, when fluoro is appropriately used it includes all imaging and 75827 should not be coded.

Diane Huston, CPC,RCC


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