Cardiology Coding Alert

Question: One of our cardiologists did an aortogram with run-off and stenting of the ostial right iliac. What are the correct procedure codes for this? Wisconsin Subscriber Answer: To code this properly, you need to examine the report carefully. Specifically, you should look at where the cardiologist started the case and whether he or she performed a platelet thromboplastin antecedent (PTA). In essence, you would report several codes when billing this procedure alone, without a regular heart catheterization, depending on how the physician approached the arteries.

The basic approach is to code it simply as an aortogram with a run-off and a stent. In this instance, the aortogram is 36200 (Introduction of catheter, aorta), and the iliofemoral run-off with just one injection on the right iliac is 75630 (Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation), appended with modifier -26 (Professional component). The stenting of the right iliac is coded 37205 (Transcatheter placement of an intravascular stent[s], [non-coronary vessel], percutaneous; initial vessel). You should also include a supervision and interpretation code that goes along with the procedure described by 37205, which is 75960 (Transcatheter introduction of intravascular stent[s], [non-coronary vessel], percutaneous and/or open, radiological supervision and interpretation, each vessel) with modifier -26.