# Help pls.... Coding Peripheral Angiography



## Goyard71 (Jul 30, 2013)

I am new at coding peripheral angiography and it's been really quite a challenge. Can you please give me some tips how to clearly understand coding peripheral angiography procedures. I have been reading the guidelines but it is still confusing me. Maybe there is an easier way to understand it.

Thank you.


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## jewlz0879 (Jul 31, 2013)

What specifically about the guidelines confuse you? Or is it applying the codes? 

75625 = Aortogram. Cath placed in RCF (right common femoral) up to aorta and aortogram performed. 

75630 = Aortogram with Bilateral run-offs; single cath position. Cath placed in LCF and tracked up to the aorta where Aortogram and complete bilateral run-off are performed. 

75710 = Unilateral lower extremity (LE) run-off. Catheter placed in RCF then selectively placed in contralateral SFA (36247) with run-off (75710). 

75716 = Bilateral extremity run-off. Abdominal aortogram (75625-26,59) for abdominal aortic aneurysm work-up and complete bilateral lower extremity run-off (75716-26,59) for claudication at the time of coronary angiography (93454-26). 

75774 = Additional selective imaging after basic exam. RFA punctured cath placement at the renals for aortogram and complete run-off (36200, 75630-26). Followed by a selective cath placement to the LCF (left common femoral) (delete 36200, add 36246) for additional images at popliteal level (75774-26). Cath advanced further into popliteal artery (delete 36246, add 36247). Final codes: 36247, 75630-26, & 75774-26. 

You wouldn't use 75774 with 75710. 

As far as the guidelines go...in order to bill 75710, 75716, 75625, 75630 & 75774 you must meet the criteria set forth by AMA CPT. 

1. There must not be a previous study done OR the decision to intervene and perform peripheral intervention is based on diagnostic study of angio's. 

2. IF a prior study was done (there is no time line set forth) but is documented in the medical record:

   A. The patient's condition since last study has changed
   B. There is inadequate visulization of the anatomy\
   C. There is a clinical _change_ during the procedure that reqires _new evaluation_ outside the  target area of current intevention. 

You may have to query your provider if he/she doesn't have solid documentation outlining medical necessity. 

If you meet the criteria, you'll need to add a 59 on the angio codes, when applicable. 

HTH


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## Goyard71 (Aug 4, 2013)

jewlz0879 said:


> What specifically about the guidelines confuse you? Or is it applying the codes?
> 
> 75625 = Aortogram. Cath placed in RCF (right common femoral) up to aorta and aortogram performed.
> 
> ...


Thank you very much for the information, Ms. Graham. This will surely be helpful.


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## ljames11 (Aug 14, 2013)

*Need help in coding a subclavian artery*

My dr is doing more and more periphals. These are the procedures that he did.. 

Select left subclavian angiography
Left subclavian artery angioplasty
Left subclavin artery stenting with a Luminexx 12x20 mm stent, self-expanding

What are the correct codes for this procedure.. Help this is driving me nuts


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## dpeoples (Aug 14, 2013)

ljames11 said:


> My dr is doing more and more periphals. These are the procedures that he did..
> 
> Select left subclavian angiography
> Left subclavian artery angioplasty
> ...



Hi ljames,
The codes that may or may not apply are:
37205/75960
35475-75962
36215/75710

however, the actual documentation is crucial in determining which code set applies. For instance, 35475/75962 should not be charged to pre-dilate an artery for stenting or for post dilating after stenting. Can you provide a report?

HTH


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## Robbin109 (Aug 15, 2013)

I took some a few peripheral classes thru Coding Strategies website. It was a big help and the class explained everything in a easy to follow format.

http://www.codingstrategies.com/csi/online-training

Also, I couldn't live with my Dr. Z's Dianostic and InterventionalCoding Reference


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## Jess1125 (Aug 15, 2013)

dpeoples said:


> Hi ljames,
> The codes that may or may not apply are:
> 37205/75960
> 35475-75962
> ...



I agree on the code choice for the stenting/PTA if applicable but wouldn't the angiogram in 2013 now be reported with code 36225? 

Jessica CPC, CCC


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