# Cerebral Arteriogram



## Jim Pawloski (Nov 26, 2012)

Hi Everyone,

I coded a patient for a cerebral arteriogram who had a meningioma.  The exam was for blood flow to the tumor which consisted of Bilateral Common Carotids, Bilateral Internal Carotids, Bilateral External Carotids, and Bilateral Vertebrals.  Ten days later, the patient has a embolization of the vessels feeding the tumor.  The doctor again selects Bilateral Internal Carotids, Bilateral External Carotids, Bilateral Vertebrals with angiography.  He then selects a branch of the right vertebral, extracrainial, and performs embolization on the meningioma.  My question/ confirmation is that I do not bill for the second diagnostic angio, since the patient had a previous angio (10 days earlier), and code just for the embolization.  Where can I get documentation (I'm blanking out on this) for not billing the second diagnostic angio in case I asked for the documentation?

Thanks,
Jim Pawloski, CIRCC, R.T. (CV)


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## dpeoples (Nov 27, 2012)

Jim Pawloski said:


> Hi Everyone,
> 
> I coded a patient for a cerebral arteriogram who had a meningioma.  The exam was for blood flow to the tumor which consisted of Bilateral Common Carotids, Bilateral Internal Carotids, Bilateral External Carotids, and Bilateral Vertebrals.  Ten days later, the patient has a embolization of the vessels feeding the tumor.  The doctor again selects Bilateral Internal Carotids, Bilateral External Carotids, Bilateral Vertebrals with angiography.  He then selects a branch of the right vertebral, extracrainial, and performs embolization on the meningioma.  My question/ confirmation is that I do not bill for the second diagnostic angio, since the patient had a previous angio (10 days earlier), and code just for the embolization.  Where can I get documentation (I'm blanking out on this) for not billing the second diagnostic angio in case I asked for the documentation?
> 
> ...



Hi Jim,
Look in the CPT book, in the Vascular Procedures heading (before CPT 75600 in my book). Under the Heading Aorta and Arteries it states:"Diagnostic angiography (RS&I) codes should NOT be used with interventional procedures for": and goes on to list contrast injections, angiography, roadmapping etc. Maybe this will help.

Be advised, this in unpopular  

HTH


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## Jim Pawloski (Nov 30, 2012)

dpeoples said:


> Hi Jim,
> Look in the CPT book, in the Vascular Procedures heading (before CPT 75600 in my book). Under the Heading Aorta and Arteries it states:"Diagnostic angiography (RS&I) codes should NOT be used with interventional procedures for": and goes on to list contrast injections, angiography, roadmapping etc. Maybe this will help.
> 
> Be advised, this in unpopular
> ...



Thank you very much for your quick response.

Jim Pawloski, CIRCC


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