# 75625 vs. 75630 w.selective angio.



## mabar1571 (Jun 28, 2011)

I thought I understood this up I got some conflicting info and now I'm confused.  

Senario-from lt.fem. placement infrarenal aortic angiogram done then cath.crossed over to rt.common iliac and selective angiogram done for rt.lower extrem.  Would you code-
75630 and 75710 or 75630 and 75774?

Next senario-abd aortogram was performed using a power injection. Following the aortogram, the cath was used to cross over to the left iliac artery. A guidewire was advanced into the SFA and a glidewire was used to perform selective angiography of the
left lower extremity. Hand injections through the left sided sheath was then used for selective angiography of the right lower extremity.  Would you code--
75630 and 75716 or 75630 and 75774 times 2?

Thanks


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## dadhich.girish (Jun 28, 2011)

*My opinion*

First scenario - 36245, 75625-26, 75710-26.

Second scenario - 36245-50, 75625-26, 75716-26.


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## dpeoples (Jun 29, 2011)

mabar1571 said:


> I thought I understood this up I got some conflicting info and now I'm confused.
> 
> Senario-from lt.fem. placement infrarenal aortic angiogram done then cath.crossed over to rt.common iliac and selective angiogram done for rt.lower extrem.  Would you code-
> 75630 and 75710 or 75630 and 75774?
> ...




If the documentation is sufficient, my code selections would be
1) 36245, 75625-26, 75710-26

2) There is conflicting info, where is the access? I don't understand how the doc can cross over from the left (left sided sheath) to the left iliac? So, assuming a typo correction (right sided sheath), and sufficient interpretation of images, I would code 36245, 75625-26, 75716-26


It is important that despite what was reported as being performed (supervision) there must also be sufficient documentation of the images (interpretation) .

HTH


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## mabar1571 (Jun 29, 2011)

my understanding was to use 75630 when all imaging is done from single cath position, even if followed by selective lower extrem.imaging.  I thought you'd only use 75625 and 75716 if full, complete studies of abd.aorta and lower extremities are done w. repositioning of cath.  

In both cases cath. was placed just infrarenal (results stated "The abd. aorta infrarenal is without angiographic disease.) then placed selectively in lower extrem.

Please, what is the basic difference in these two codes?


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## dpeoples (Jun 29, 2011)

mabar1571 said:


> my understanding was to use 75630 when all imaging is done from single cath position, even if followed by selective lower extrem.imaging.  I thought you'd only use 75625 and 75716 if full, complete studies of abd.aorta and lower extremities are done w. repositioning of cath.
> 
> In both cases cath. was placed just infrarenal (results stated "The abd. aorta infrarenal is without angiographic disease.) then placed selectively in lower extrem.
> 
> Please, what is the basic difference in these two codes?




The difference (other than a subjective interpretation) is catheter movement, in both the examples you give, the catheter is moved from the aorta into the contralateral iliac.

For a good reference, try Zhealth publishing or Medical Asset Management in Atlanta. There are others but I am most familiar with those.


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## mabar1571 (Jun 29, 2011)

ok, let's see if i understand this now.  In general, if cath.is placed at or below level of renals and injected, and then cath.is moved into legs (either unilat-75710 or bilat-75716) then you would bill 75625.  You would only use 75630 if cath.was placed at or below level of renal and injected and no other studies were done.

Is there any case where you would bill for 75630 and 75710 or 75716?

And if cath was just placed in bifurcation (no interpret.of aorta) and both extremities were injected and results obtained you would just use 75716-correct?

And when would you bill for 75774?  For example-if cath.was placed infrarenal (from, say LFA) and injected w.results documented on aorta then moved to RFA and selectively injected then moved down to rt.poplit and selectively injected and then moved back up and over to left side and left common iliac selectively injected you would bill
75625
75716
75774 
(plus 36247 for cath.to poplit)


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## theresa.dix@tennova.com (Jun 29, 2011)

mabar1571 said:


> ok, let's see if i understand this now.  In general, if cath.is placed at or below level of renals and injected, and then cath.is moved into legs (either unilat-75710 or bilat-75716) then you would bill 75625.  You would only use 75630 if cath.was placed at or below level of renal and injected and no other studies were done.
> 
> Is there any case where you would bill for 75630 and 75710 or 75716?
> 
> ...




75630 is only coded when the catheter is placed at the level of the renals and one fluid injection is provided to view the abdominal thru the femoral arteries bilaterally (at least to the common femoral). Interpretation.


75625 & 75716 Multiple injections ( high and low) basic exam is one injection in the abdominal aorta and a 2nd injection at the aortic bifurcation.

example of using 75774 is; The physician access the left femoral artery and places the catheter at the level of the renals and with one fluid injection he/she views the abdominal aorta thru the femoral arteries bilaterally. They notice something unusal in the right SFA and manipulates the catheter to the right SFA and provides an addtional selective injection

75630, 36247 & 75774

The only time to use 75774 is when you have a selective cath placement.


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