Cardiology Coding Alert

Question: When should I use the new HCPCS G codes for extremity artery studies, and when should I use 75710? Medicare told us that 75710 is still a valid code with the proper modifiers. But we have billed G0278 and gotten paid in the past.

Pennsylvania Subscriber
 
Answer: Your question seems to be specific to extremity studies the physician performs at the time of a heart cath. In these situations, you would use 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation) if the physician performed a selective contralateral extremity study without a non-selective study (G0278, Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation [list separately in addition to primary procedures]).

If the physician performed a non-selective study (G0278) followed by a contralateral, selective study, then +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation [list separately in addition to code for primary procedure]) would be more accurate. You  would also need to report the appropriate selective catheter placement code.  
 
-- You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, CHCC, CPC, president of Compliant MD Inc. and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr. MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.