Cardiology Coding Alert

Question: I think I goofed and reported 36245, 75724, and 75625 together. I changed the 75625 to G0275, and now Medicare is asking for money back. What should I do?


Connecticut Subscriber

Answer: If your cardiologist performed a bilateral selective renal aortogram, you should report 36245 (Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family) twice and 75724-26 (Angiography, renal, bilateral, selective [including flush aortogram], radiological supervision and interpretation).

You may want to apply modifiers -LT-59 (Left side; distinct procedural service) and -RT-59 (Right side; distinct procedural service) to each reporting of 36245. Payers differ on which modifiers are necessary for prompt adjudication of claims with bilateral renal artery catheter placement.

You cannot use 75625 (Aortography, abdominal, by serialography, radiological supervision and interpretation) or G0275 (Renal artery angiography [unilateral or bilateral] performed at the time of cardiac catheterization, includes catheter placement, injection of dye, flush aortogram and radiologic supervision and interpretation and production of images [list separately in addition to primary procedure]). So, you probably should have just voided the 75625 to begin with.