Cardiology Coding Alert

Question: My understanding is that the provider needs to inject at the aortic root and look for patency of the aorta to report +93567. If the provider documents injecting at the base of the ascending aorta with findings confirming occlusion of the vein graft to the RCA and radial artery graft to the obtuse marginal graft, can I report +93567 or 75625? Or is this unbillable roadmapping?

Nebraska Subscriber

Answer: Proper coding for this service depends on the intent behind imaging the grafts.

Code +93567 (Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography [List separately in addition to code for primary procedure]) applies to medically necessary evaluation of the aortic root or ascending aorta.

Examples include looking for aortic root disease, valvular heart disease, or congenital heart disease.

You should not report +93567 if the physician injects contrast because he needs help locating the patient’s grafts. That imaging is included in the payment for the graft studies.

Similarly, if the cardiologist injects contrast to help visualize the coronary ostia, which are the origins of the coronary arteries, as part of coronary angiography, you should include that service in the coronary angiography.

Code 75625 (Aortography, abdominal, by serialography, radiological supervision and interpretation) would not be appropriate as it represents imaging of the abdominal aorta. However, if the physician images the aorta and identifies an abdominal aortic aneurysm, it may be appropriate to code 75625 during a heart catheterization, dependent on the physician’s intention.