You Be the Coder:
Coding Abdominal Aortagram with Runoff
Published on Sat Feb 01, 2003
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our physician placed a catheter in the patient's right common femoral artery, positioned the catheter in the proximal abdominal aorta and performed an abdominal aortogram. He pulled the catheter down to the level just above distal aortic bifurcation and performed bilateral iliac angiograms. Next, he positioned the catheter over the aortic bifurcation and into the left external iliac artery and performed a left-lower extremity runoff. To better visualize the vessels below the left knee, he positioned the catheter over a wire selectively into the distal left superficial femoral artery and performed an additional contrast injection. He removed the catheter over a wire and the right-lower extremity and performed a runoff using contrast. How should we report this procedure? Wisconsin Subscriber
Answer: You would report 36247 (Selective catheter placement, arterial system; initial third-order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family) for the selective catheter placement in the left superficial femoral artery (SFA). Next, report 75625 (Aortography, abdominal, by serialography, radiological supervision and interpretation) for the abdominal aortagram and append modifier -26 (Professional component) if the physician is performing the service in the hospital rather than the office. Report 75716 (Angiography, extremity, bilateral, radiological supervision and interpretation) and append modifier -26 if the physician performs the procedure in the hospital rather than the office for the bilateral extremity study above the bifurcation. Add +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation [list separately in addition to code for primary procedure]) and append modifier -26 for the selective study shot at the external iliac artery on the left, the selective study of the SFAon the left, and the selective study on the right.