Cardiology Coding Alert

Reader Question ~ Venogram Is Not Separate From Insertion

Question: Can I bill a venogram with a CRT-D?

Idaho Subscriber Answer: No, you should include the venogram in +33225 (Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of pacing cardioverter-defibrillator or pacemaker pulse generator [including upgrade to dual chamber system] [list separately in addition to code for primary procedure]).

Rationale: The national Correct Coding Initiative includes 75820 (Venography, extremity, unilateral, radiological supervision and interpretation) and 36005 (Injection procedure for extremity venography [including introduction of needle or intracatheter]) with pacemaker and implantable cardioverter defibrillator procedures.

Watch out: You might be tempted to report 75860 (Venography, venous sinus or jugular, catheter, radiological supervision and interpretation). But this is incorrect because this code is specific to venograms of the skull area.  
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