Cardiology Coding Alert

The debate regarding correctly billing G0275 and G0278 the new HCPCS codes for renal and iliac artery angiography continues, but CMS may be stepping in soon to settle the score.

The May 2003 Cardiology Coding Alert Extra article "New G Codes Alter Renal and Iliac Angiography Billing" provided guidance about these codes based on a March 2003 statement from a CMS coding source on applying these codes.

Specifically, the CMS source instructed that codes G0275 (Renal artery angiography [unilateral or bilateral] performed at the time of cardiac catheterization, includes catheter placement, injection of dye, flush aortogram and radiologic supervision and interpretation and production of images [list separately in addition to primary procedure]) and G0278 (Iliac artery angiography performed at the same time of cardiac catheterization, includes catheter placement, injection of dye, radiologic supervision and interpretation and production of images [list separately in addition to primary procedure]) should be "reported after a heart cath, regardless if bilateral or unilateral or selective in nature."

Even so, other Medicare sources had previously given direction that G0275 and G0278 are for nonselective use only or that coders should wait to bill these codes until CMS issues clear directions regarding correct application of these codes. Conflicting advice leaves coders wondering what to do. But answers are forthcoming. According to the American College of Cardiology (ACC), "the ACC and CMS are working to resolve the confusion" over billing these codes, says an ACC spokesman. The ACC further indicates that it doesn't have a definite deadline for the resolution yet.

Until the conflict is resolved, however, coders should continue to consult their local carriers for guidance.