Cardiology Coding Alert

Question: At the end of a left heart catheterization, the cardiologist performed a unilateral lower-extremity angiogram as part of placing the vascular plug in the access site. May I report the angiogram?

Utah Subscriber

Answer: No. You should not report this lower-extremity angiogram separately.

Here's why: The National Correct Coding Initiative Manual, Chapter 11, states that a "provider should not report an associated imaging code such as CPT code 75710 or HCPCS code G0278" when placing "an occlusive device such as an angio seal or vascular plug into an arterial or venous access site after cardiac catheterization or other diagnostic or interventional procedure" (www.cms.hhs.gov/NationalCorrectCodInitEd/).

Watch out: The manual also states that the correct code for placing the plug at the access site is G0269 (Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure [e.g., angioseal plug, vascular plug]).

But you'll find that the Medicare physician fee schedule does not price this code and gives it a "B" status indicator, which means payment is bundled into other services.

CMS intends the code for hospital tracking purposes.

Private payers may reimburse G0269, so you should check with your payers and ask for their policies in writing.

--You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC, ACS-CA, CHCC, president of CardiologyCoder.Com.