Cardiology Coding Alert

Question: When billing a 93544 (injection procedure for aortography), should I bill one or both of the following for the radiology supervision: 93556 or 75625?

Ruth Fishe
Academic Cardiology Associates

Answer: When billing cath/angiogram services, dont use 75625 (aortography, abdominal, by serialography, radiological supervision and interpretation) for a cath/angio S&I code. While its true that the CPT manuals description of 75625 does follow with a reference to 93544, this code should not be used if a cardiologist performs the heart cath/angiogram. Bill the appropriate placement code (i.e., 93501-93533), along with 93544 and 93556. Although 75625 and 93556 do not appear in the National Correct Coding Initiative, it would be considered upcoding to bill for both because the S&I codes are intended to only be reported one time per procedure. (Remember to check your documentation carefully. Depending on what your cardiologist did, you also might be able to bill for 93555.)

Codes from the 70000 and 30000 ranges are usually reserved for occasions when an interventional radiologist and a cardiologist perform the cath/angiogram together. (The cardiologist performs the placement and the interventional radiologist performs the injection as well as the S&I. If this is the case, the normal three-step process for coding a cath and angiogram is suspended; the cardiologist would not bill for an injection or an S&I code, but only a placement code from the 93501-93529 range. The radiologist should bill for the injection procedure from the codes 93541-93545 or 36000 range. (Remember the cardiologist report is calculated in the Relative Value Unit of the placement code for the cath. Therefore, the cardiologist cannot bill extra for the report when the radiologist is performing injection and S&I services.)