# Interventional Radiology questions



## happycoder07 (Jul 22, 2008)

Hello, these are 2 questions from an exam my friend was taking and she wanted me to ask about the answers if anyone can help I would appreciate it.  She is currently in school and sitting for the CPC exam later this year and I thought this would be a good place to ask.  

1.	ASPVD of the Iliac artery.  Via a right transfemoral route, a cath is placed selectively in each internal Iliac artery and angiogram was performed, a PTA with stent placement of the right was also performed, follow up angiogram showed no stenosis.  
Diagnosis:
Procedure: ICD-9
               CPT

2.	Carotid Stenosis of the right artery. A Selective angiogram was performed via the right femoral with catheter placement in the RT Common and Left Common Carotids.
Diagnosis:
Procedure: ICD-9
               CPT
Thanks,
Pedenia


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## Shirleybala (Jul 22, 2008)

*Bilateral internal iliac*

Bilateral internal iliac and stent placement
1)CPT CODES:36246
                   36245-59
                   75736-26
                   75736-26,59
                   37205
                   75960-26
            ICD:440.8
Thanks
Shirley


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## Shirleybala (Jul 22, 2008)

*Bilateral common carotid*

Bilateral common carotid
1)CPT CODES:36216
                   36215-59
                   75680-26


ICD:433.10


Thanks
Shirley


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## FTessaBartels (Jul 23, 2008)

*Ethical problem*

I do not think we should be giving students answers to test questions. They need to learn how to find the answers on their own, not just rely on a forum where more experienced coders will given the answers. 
Just my opinion
F Tessa Bartels, CPC, CPC-E/M


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## happycoder07 (Jul 23, 2008)

Thanks Shirley for your response.

F Tessa she already took the test and was graded she didn't get these 2 correct.  I should have written that initially.  I don't want to be unethical in the forum.  No harm intended.

Pedenia


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## Shirleybala (Jul 23, 2008)

Hi

Sorry for giving answers , i dont know the forum ethic ,hereafter i only give suggestions.

Thanks,
Shirleybala


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## FTessaBartels (Jul 24, 2008)

*Providing answers / suggestions*

Pedenia,
You're a peach of friend to try to help your friend understand coding. It can definitely be complicated!

However, I think your friend would be better served by asking her instructor what the correct answer is and why *her* response was incorrect. This way the student not only learns the correct answer, but learns what about the scenario or the coding protocols in CPT make one answer correct and one answer incorrect. 

I've certainly missed the mark (as, I'm sure, we all have) when for whatever reason we overlook a word or phrase in a scenario that makes a difference in selecting the correct code. So, while there was no harm done, since the student had already taken the test and been graded, giving our answers to the scenario doesn't entirely help the student, either. 

Learning to think through the rationale for one code vs another code is part of being a professional coder.

Best of luck to your friend in taking the CPT exam; she already has one resource to network with for future on-the-job puzzles, so she's ahead of the pack.

F Tessa Bartels, CPC, CPC-E/M


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## happycoder07 (Jul 24, 2008)

Thanks F Tessa and don't think I didn't direct her to the teacher (let me write this my friend half listens)   

I am sure she will do fine on the exam, I told her she second guesses herself too much but hopefully that will pass one day.

Pedenia


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## jifnif (Aug 8, 2008)

I don't think that is completely fair.  I am new to some aspects of coding although I have been coding for over eleven years.  Sometimes I cannot get the correct answer even if I attempt 100x in interventional radiology.  It is not always so easy and a more experienced coder or someone who can see it from a different perspective is just what is needed.  Then the person with lesser knowledge can go "ooooooh, i get it now".  Sometimes we all need an outside opinion and where else can you get one from if we can' get it from this forum?


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## lisammy (Aug 13, 2008)

Ok ethical questions behind us. Does anyone agree with the answer given for the iliac stent?  Looks more like 
37205
36246
75960-26
possibly also a 75736-26 if it has not been documented that the stenosis was already seen on a previous agram then a -59 would need to be added to the 75960-26


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## stgregor (Aug 18, 2008)

lisammy said:


> Ok ethical questions behind us. Does anyone agree with the answer given for the iliac stent?  Looks more like
> 37205
> 36246
> 75960-26
> possibly also a 75736-26 if it has not been documented that the stenosis was already seen on a previous agram then a -59 would need to be added to the 75960-26



Actually, the -59 goes on the 75736. That's the component/edited procedure. The bilateral _internal_ iliac arteries are coded as 36245-59 (ipsilateral), 36246 (contralateral). 75736 would be coded for each side (one RT, one LT), so you'd have 75736-26-59-RT, 75736-26-59-LT. As you mentioned, the diagnostic angiographies would only be coded if the CPT criteria for coding diagnostic angiography are met - i.e.: 
- No prior catheter-based angiographic study is available and a full diagnostic study is performed, OR 
- A prior study is available but, as documented in the medical record, the patient's condition with respect to the clinical indication has changed since the prior study, OR
- There is inadequate visualization of the anatomy and/or pathology, OR
 -There is a clinical change during the procedure that requires new evaluation outside the target area of intervention).


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## Hariharan (Sep 6, 2008)

I think


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## montoyag (Sep 25, 2008)

*new to interventional radiology coding*

we have a new neurosurgeon that does interventional radiology procedures, I have no experience in this field, would anyone be willing to teach me?
Thank you!


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## Shirleybala (Dec 10, 2008)

ya sure i also studied like this only ,ready to help for ur queries upto my knowledge,AAPC forum helped me a lot specially mindys(A member of AAPC)


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## rparikh (Mar 4, 2012)

I need help with coding on following Procedures:

1) Carbon dioxide angiography of the left iliac artery
2) Carbon dioxide angiogram of the right iliac artery and right internal iliac artery.
3) Intravascular ultrasound of the left common iliac artery.
4) Coiling of the right internal iliac artery with multiple EV3 coils.
5) Stenting of the right common iliac artery with a Viabahn covered stent.
6) Preclosure of the arteriotomy site with 2 Perclose devices.


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## donnajrichmond (Mar 5, 2012)

rparikh said:


> I need help with coding on following Procedures:
> 
> 1) Carbon dioxide angiography of the left iliac artery
> 2) Carbon dioxide angiogram of the right iliac artery and right internal iliac artery.
> ...



All on the same patient, same session? 
# 1 and # 2 - which iliac artery?


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