# question on 2011 peripheral coding (sample given)



## kellyjoy86 (Dec 23, 2010)

I am curious about something and I hope some one can help me figure this out.  Just for instance, if Dr. A was performing a angiogram of external iliac and finds no disease, then moves to the internal iliac and performs an angio and finds disease and he them performs an angioplasty in the internal iliac. Now with the new 2011 peripheral guidelines is it safe to code for the external iliac placement and angio, becuase the external iliac is considered a separate territory from the internal iliac.  Or would the cath placement and angio in the external iliac be included in the angioplasty that was done in the internal iliac? if anyone has any insight on this please message me back. 

Thanks a bunch, 
Kelly CPC


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## Jim Pawloski (Dec 23, 2010)

kellyjoy86 said:


> I am curious about something and I hope some one can help me figure this out.  Just for instance, if Dr. A was performing a angiogram of external iliac and finds no disease, then moves to the internal iliac and performs an angio and finds disease and he them performs an angioplasty in the internal iliac. Now with the new 2011 peripheral guidelines is it safe to code for the external iliac placement and angio, becuase the external iliac is considered a separate territory from the internal iliac.  Or would the cath placement and angio in the external iliac be included in the angioplasty that was done in the internal iliac? if anyone has any insight on this please message me back.
> 
> Thanks a bunch,
> Kelly CPC



My understanding is that if you do a true diagnostic angio, and then the intervention was performed, then you can bill for both using modifier -59.
HTH,
Jim Pawloski, CIRCC


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## Jess1125 (Dec 23, 2010)

That's my understanding as well.

Jessica CPC, CCC


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## OliviaPrice (Dec 27, 2010)

Jim Pawloski said:


> My understanding is that if you do a true diagnostic angio, and then the intervention was performed, then you can bill for both using modifier -59.
> HTH,
> Jim Pawloski, CIRCC



Just to clarify....you are saying we can bill the cath placement, angio, & intervention?  It was my understanding that we could not bill the cath placement once an intervention is performed regardless of the fact that we did a complete diagnostic angiogram.


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## Jess1125 (Dec 27, 2010)

Okay, looking at the CPT guidelines, I would say we can only bill for the angiogram with a 
-59 modifier if we did a true diagnostic study.

"If diagnostic angiography is necessary, is performed at the same session as the interventional procedure and meets the above criteria, modifier -59 must be appended to the diagnostic radiological supervision and interpretation code(s) to denote that diagnostic work has been done following these guidelines."

Jessica CPC, CCC


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