Cardiology Coding Alert

Question: When did G0278 start specifying it was for non-selective services?

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Answer: Since before 2010, non-selective has been part of the descriptor of 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 procedure]).

The short version of the history is that CMS published the definition of G0278 without the term non-selective in 2003. Conflicting guidance from Medicare left coders unsure of whether the code applied to only non-selective services, although eventually using the code only for non-selective services became the norm. Finally, about seven or eight years ago, the term non-selective made its way back into the definition for good, matching the code language to the code’s intent.

For selective services, you should use the appropriate CPT^® codes, such as 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation) and a catheterization code, if appropriate.