# Rule out stenosis w/ CTA of renal artery



## 634sg4fs65g4fg (May 26, 2010)

What dx could I use for this? Our dr. wants to rule out stenosis by having patient do CTA of renal artery, would I use V71.9 and also stenosis code? He is having pt do this at hospital so we just need the code to set up procedure but she is Medicare. Help!!!!!


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## 634sg4fs65g4fg (May 26, 2010)

I wanted to add that patient currently has dx of 424.0 but that is concentrated for coronary, would that be okay for ruling out renal stenosis? Any help is really appreciated!!!!


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## sbicknell (May 26, 2010)

My first thought is what is going on that your physician wants to rule-out stenosis. Pt have HTN, urinary complaints? If there is nothing to support ordering this, then you will have to code it as a screening and the payer probably will deny for medical necessity

Like you say, the 424.0 is irrelevant for a renal study. You are probably going to have to ask the physician why he is ordering and then he needs to document that by amending the note


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## 634sg4fs65g4fg (May 26, 2010)

Yes, patient has 402.10, we could use that?


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## sbicknell (May 26, 2010)

yes, you can use 402.10

a couple of points:  
1) make sure the 402.10 is supported in the note where he orders the test. In a perfect world it would be clearly stated in his MDM
2) if an external facility is doing this CTA make sure the 402.10 is on the order
3) if medicare, check and see if you have any LCDs on what DX support medical necessity for the CTA


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