# 75630 vs 75625, 75716



## suela923@aol.com (Aug 15, 2013)

I thought this should be billed as 75630 because the patient's H&P indicated evaluation of enlarging aortic aneurysm, Dr. Z's book indicates that the movement of the cath twice is ok for 75630.  But am being told it's two separate studies and should be 75625, 75716.  Can anyone explain why to me?  I seem to have a hard time deciding when to use 75630.  Thanks!


 Procedure: Aortoiliac angiogram. Bilateral leg runoff.

Indication: Peripheral vascular and visceral occlusive disease. Aortic aneurysmal degeneration.

Results: Patient was identified and brought to the vascular unit. The left groin was prepped and draped in the usual sterile fashion. 2% lidocaine was used to infiltrate the skin over the left femoral artery. An angiographic needle, wire, and 5-French sheath were then placed. A flush catheter was placed at the level of the visceral aorta. Using DSA and power injection, aortoiliac angiography was obtained. Additional views of the visceral aorta were obtained in the lateral position. Catheter was then pulled down to the aortic bifurcation and additional views of the pelvis were obtained in an RAO and LAO projection. A bilateral runoff view of the legs was then performed. At the completion of the case, the catheter was removed and the sheath was removed and the left groin was sealed with a closure device. Patient tolerated the procedure well and left in stable condition.

Findings are as follows. Single patent renal arteries bilaterally. There is no significant stenosis seen. The infrarenal aorta is aneurysmal but patent and free of occlusive disease. There is a stent in the celiac artery, this is occluded. There is a stent in the superior mesenteric artery, this is patent with only mild stenosis. 

The right common iliac artery appears to be patent with only mild orificial stenosis. The internal and external iliac arteries are patent on the right. The right leg runoff shows a patent common femoral artery, profunda femoris artery, and superficial femoral artery. There is no stenosis seen. The right popliteal artery is patent above and below the knee. The tibioperoneal trunk is patent. All 3 tibial vessels are patent to the foot on the right.

The left leg runoff shows a patent left common iliac artery, however, again, there is mild to moderate orificial stenosis. The internal and external iliac arteries are patent without stenosis. The left common femoral and profunda femoris arteries are patent without stenosis. The left SFA is patent. There is mild stenosis in its mid segment. The popliteal artery is patent above and below the knee. The tibioperoneal trunk is patent. All 3 tibial vessels are patent to the foot. Anterior tibial artery occludes at the ankle.


Result Impression 


Occluded celiac artery and stent. Aneurysmal degeneration of the infrarenal aorta. Mild stenoses in the proximal common iliac arteries. Tibial vessel occlusive disease as described above.


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## Jim Pawloski (Aug 15, 2013)

suela923@aol.com said:


> I thought this should be billed as 75630 because the patient's H&P indicated evaluation of enlarging aortic aneurysm, Dr. Z's book indicates that the movement of the cath twice is ok for 75630.  But am being told it's two separate studies and should be 75625, 75716.  Can anyone explain why to me?  I seem to have a hard time deciding when to use 75630.  Thanks!
> 
> 
> Procedure: Aortoiliac angiogram. Bilateral leg runoff.
> ...



75630 is used when the aorta and pelvic vessels are imaged, or if the aorta and a bilateral lower extremity angio is performed from one catheter position.  75625 and 75716 is used when a full and complete aortogram (Need renal arteries to be described) and bilateral lower extremity arteriogram is performed.
HTH,
Jim Pawloski, CIRCC


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## suela923@aol.com (Aug 16, 2013)

Per Dr. Z...do use code 75630 for aorto-pelvic angiography performed for AAA work-up, despite any catheter movement between the aortic and the pelvic oblique study...in reading this report I feel that is exactly what was perform and that 75630 would be appropriate.....any thoughts?????


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