Cardiology Coding Alert

Question: Which codes should I use for the following iliofemoral angiography procedure? The cardiologist placed a femoral intra-aortic balloon pump sheath in the left femoral artery of a patient who had severe coronary artery disease. The cardiologist next performed a left iliofemoral digital subtraction angiography and inserted the balloon over the J-tipped guidewire and positioned it in the descending aorta below the orifice of the left subclavian artery and initiated intra-aortic counterpulsation. Would I use 75630, 75710, or would another code be more appropriate?

Iowa Subscriber

Answer: Report 33967 (Insertion of intra-aortic balloon assist device, percutaneous) for intra-aortic balloon pump implant. For the angiography, you would need to check the physician's documentation for findings and to determine whether the procedure was a diagnostic study. For instance, to report the angiography, you would need to look for indications in the report that the physician performed a full lower extremity angiography and run off. The physician would need to document findings from the iliac and femoral systems, as well as distal runoff.