# Aortagram thoracic serialogram



## suela923@aol.com (May 3, 2013)

I was going to bill:
75605 thoracic aortogram
36222 left common carotid
36215, 75710 left subclavian

my trainer told me that 75605 was not billable....I am not understanding her reasoning....can anyone explain this to me?   

What constitutes a complete thoracic aortogram?

Thank you!!!




Procedure: Thoracic aortic arch angiogram. Selective injection of the left subclavian 

artery. Selective injection of the left common carotid artery.

Indication: Significant thoracic vessel occlusive disease.

Results: Patient was identified and brought to the vascular unit. The right groin was prepped and draped in the usual sterile fashion; 2% lidocaine was used to infiltrate the skin over the right femoral artery. An angiographic needle, wire, and 5-French sheath were then inserted. A 90 cm pigtail flush catheter was inserted to the level of the ascending aortic arch. Using DSA and power injection thoracic aortic arch angiogram was performed and multiple obliquities. This catheter was then exchanged out for a Vert catheter and selective injection of the left subclavian artery and left common carotid artery were performed. At the completion of the case the catheter and sheath were removed. The right groin was sealed with a closure device. Patient tolerated procedure well and left in stable condition.

Findings are as follows. The ascending, transverse, and proximal descending aortic arch are patent without stenoses. The innominate artery is patent without stenoses. The right subclavian artery appears to be patent without stenoses. The right common carotid artery appears to be patent without stenoses. The right vertebral artery appears to be patent without a visible significant stenoses. The left common carotid artery is patent with mild orificial stenoses. The left subclavian artery appears to be patent with only mild orificial stenoses. The left axillary artery appears to be patent as well. The left vertebral artery appears to be patent with no significant stenoses.

IMPRESSION:


Mild orificial stenoses of the left common carotid artery and left subclavian artery.


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## dpeoples (May 3, 2013)

suela923@aol.com said:


> I was going to bill:
> 75605 thoracic aortogram
> 36222 left common carotid
> 36215, 75710 left subclavian
> ...



This is an (thoracic) arch study. The code used to be 75650 (deleted), but now is 36221. However, this is included with any _selective_ head/neck  angiogrpahy ( in this case 36222). 

HTH


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## suela923@aol.com (May 3, 2013)

Oh I should have seen that...thanks!


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## fmuldoon (May 3, 2013)

*Fran Muldoon*

Code 75605 identifies serialographic imaging of the thoracic aorta. In this procedure, a number of serial images is taken of the thoracic aorta (similar to obtaining movie frames) to obtain an image of the aorta at this level. 

Hope this helps explain when this cpt code should be used.


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