# 75774 - I am confused on when it is appropriate to bill



## brittany1356 (May 6, 2015)

I am confused on when it is appropriate to bill CPT 75774. I bill for a vascular interventionalist. 

What is considered the "basic exam" 

If my doctor is performing a diagnostic study and enters through the radial artery he performs an abdominal aortogram and then selectively engages the right common iliac artery and does selective injections and then advances the catheter to the common femoral artery and does selective injections from there also. He does this on the left side also

I am billing 36246 x2, 75710, 75625 would it be appropriate to bill 75774 and if so, x2 or 4?

TIA!!


----------



## Jim Pawloski (May 8, 2015)

brittany1356 said:


> I am confused on when it is appropriate to bill CPT 75774. I bill for a vascular interventionalist.
> 
> What is considered the "basic exam"
> 
> ...



In this description you have given, the basic exam would be the extremity angio - 75710, then with the catheter movement and imaging you can bill 75774.  For the catheter placement, how far did the catheter go?  That is what you bill for.  So for your example, I would code 36246 for the common femoral selectivity, 75625 for the abdominal aortogram, 75710 for the rt lower extremity angio. and 75774 for additional after the basic.
HTH,
Jim Pawloski, CIRCC


----------



## Chlrtrep (May 8, 2015)

Originally Posted by brittany1356 View Post 
I am confused on when it is appropriate to bill CPT 75774. I bill for a vascular interventionalist. 

What is considered the "basic exam" 

 selectively engages the *right common iliac artery *and does selective injections and then advances the catheter to the common femoral artery and does selective injections from there also. *He does this on the left side also*I am billing 36246 x2, 75710, 75625 would it be appropriate to bill 75774 and if so, x2 or 4?

TIA!! 

In this description you have given, the basic exam would be the extremity angio - 75710, then with the catheter movement and imaging you can bill 75774. For the catheter placement, how far did the catheter go? That is what you bill for. So for your example, I would code 36246 for the common femoral selectivity, 75625 for the abdominal aortogram, 75710 for the rt lower extremity angio. and 75774 for additional after the basic.
HTH,
Jim Pawloski, CIRCC 



I do not think this would be coded as unilateral 75710 as both Rt and LT extremity were imaged 75716

The question I have regarding the use of 75774 is whether or not these were truly additional selective angiograms or the physicians method of completing a bilateral runoff.    Just my thoughts.


----------



## Jim Pawloski (May 8, 2015)

Chlrtrep said:


> Originally Posted by brittany1356 View Post
> I am confused on when it is appropriate to bill CPT 75774. I bill for a vascular interventionalist.
> 
> What is considered the "basic exam"
> ...



I missed the "he does the same thing on the left"  as for 75774, I don't think there really wasn't enough info to debate the 75774.
Thanks,
Jim


----------



## mikereyland (Oct 13, 2021)

Only report 75774 if there was a documented reason for needing to perform the extra angiogram such as an occlusion.  This sounds like a staged angiogram which it is inappropriate to report 75774.  75710 and 75716 is for the entire extremity NOT per contrast injection.


----------



## Jim Pawloski (Oct 14, 2021)

Best example is using the liver. When the celiac is selected and imaged, you would bill 75726. Catheter is moved to the GDA and is injected, that is when you would use 75774 for the injected. Then the catheter is moved to the right hepatic artery, then you would code for 75774 for that injection. So 75726 is the basic exam- celiac, and the rest are imaging after the basic. Same thing goes for the SMA.  As for 75710 and 75716, yes it is for the entire extremity ( I go at least to below the knee.)


----------

