Cardiology Coding Alert

Question: When the physician does an interventional stent placement --" such as, in an extremity --" sometimes they also perform follow-up angiography. Should I always bill for that? Tennessee Subscriber Answer: No, not typically. When you can: For diagnostic angiography to be separately billable at the time of an intervention, your cardiologist should clearly document the study as diagnostic and that it took place in a different anatomic area. For instance, the cardiologist places a stent in the common iliac artery and then performs a truly diagnostic study of the more distal vessels: superficial femoral, popliteal and tibial-peroneal distribution.  When you can't: If your cardiologist does an intervention, however, and then after the intervention, he wants to look to see how the intervention worked, you cannot bill for the follow-up angiography.   Think of it this way: In this case, the cardiologist is mainly asking, If I deployed a stent, is it positioned appropriately? Do I have good seating of the stent? Is there any dissection that is going to limit the blood flow? Did I fully address the lesion, or do I need to place two or three more stents? This procedure is included in the codes that you use for stent placement (such as, 37205, Transcatheter placement of an intravascular stent[s] [except coronary, carotid, and vertebral vessel], percutaneous; initial vessel; and 75960-26, Transcatheter introduction of intravascular stent[s] [except coronary, carotid and vertebral vessel], percutaneous and/or open, radiological supervision and interpretation, each vessel; professional component).