# Distal aortogram with bilateral iliograms



## MADDIE (Sep 25, 2013)

What would be the correct codes for the following:
 Right common femoral artery was punctured under ultrasound guidance using an 18-gauge needle. J- wire was inserted into aorta and exchanged for a 4 -French sheath. An ultra flush catheter was advanced into the distal aorta and a distal aortogram with bilateral iliograms was performed. Then an ultra flush catheter with guide wire was placed in the distal external iliac artery and a left lower extremity angiogram was performed.

Findings: patent aortoiliac segment bilaterally. Patent left common femoral artery, SFA and profunda, popliteal artery. Diseased TP trunk and occluded AT, PT . Primary runoff is via peroneal to the left foot.

Thanks for any help


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## dpeoples (Sep 25, 2013)

MADDIE said:


> What would be the correct codes for the following:
> Right common femoral artery was punctured under ultrasound guidance using an 18-gauge needle. J- wire was inserted into aorta and exchanged for a 4 -French sheath. An ultra flush catheter was advanced into the distal aorta and a distal aortogram with bilateral iliograms was performed. Then an ultra flush catheter with guide wire was placed in the distal external iliac artery and a left lower extremity angiogram was performed.
> 
> Findings: patent aortoiliac segment bilaterally. Patent left common femoral artery, SFA and profunda, popliteal artery. Diseased TP trunk and occluded AT, PT . Primary runoff is via peroneal to the left foot.
> ...



I would code:
36246/75710
75625 (I think there is just enough documentation for this) 
I am wondering if there is more to the report? what is the medical necessity?

HTH


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## MADDIE (Sep 25, 2013)

The patient has hx of diabetic ulceration of the left fifth toe for which a fifth toe ray amputation was perfomed. However, wound is not healing.


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## TWinsor (Sep 30, 2013)

Danny, 

Quick question;  I thought there had to be documentation of the renal arteries to bill 75625.  Isn't the distal aortogram included in the lower extremity angios?

Thanks,
Terri


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## dpeoples (Sep 30, 2013)

TWinsor said:


> Danny,
> 
> Quick question;  I thought there had to be documentation of the renal arteries to bill 75625.  Isn't the distal aortogram included in the lower extremity angios?
> 
> ...



Terri,
 the documentation does not "have" to include the renals, but that is usually a slam dunk for 75625. Also, that is the reason I asked about medical necessity (for the aortogram). After getting that, I would probably not bill/code for the aortogram due to the lower extremity symptom/condition.

My new thoughts are just 36246/75710.

HTH


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## carelitz (Dec 4, 2020)

TWinsor said:


> Danny,
> 
> Quick question;  I thought there had to be documentation of the renal arteries to bill 75625.  Isn't the distal aortogram included in the lower extremity angios?
> 
> ...



I have read this several times on here. Where can i find documentation to support  this please? I am searching everywhere!  Thank you!


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## Jim Pawloski (Dec 11, 2020)

If you have a Z-health Publishing book, it states in there that if the catheter is placed in the distal aorta and the lower extremities are imaged, the distal aorta imaging is part if the lower extremity imaging.

HTH,
Jim Pawloski, CIRCC


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