Cardiology Coding Alert

Question: How should I code "angiogram of the right iliac artery"? The cardiologist performed it with a left heart catheterization. Should I use 75710 and 36245? North Carolina Subscriber Answer: Without reviewing the operative report, this question is difficult to answer.

To use 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation), the cardiologist would need to evaluate more than just the right iliac. The physician would have to have documented a right-lower extremity arterial evaluation in his or her notes.

If the cardiologist injected the iliac through the sheath for the femoral artery evaluation for the use of a closure device, you cannot code it separately. If he or she made the injection due to difficulty with access or advancing the guidewires or catheters, then you would code 75710-26 (Professional component). You would need a peripheral vascular disease diagnosis to support the medical necessity of the 75710-26 with a heart catheterization.