Cardiology Coding Alert

Question: The physician accessed the right radial artery via the Seldinger technique. They placed a 6-French sheath in the right radial artery. 2.5mg of Verapamil, 800mcg of nitroglycerin, 1mg of Lidocaine, and 5000U of Heparin were given through the arterial sheath. The physician placed a PV multi-curve in the distal abdominal aorta where distal abdominal aortography was performed. They also performed bilateral iliofemoral angiography. Following this, the physician removed the apparatus and the sheath, and hemostasis was achieved using TR banding. The patient was transferred to the postop holding in stable condition. How should I report this procedure?

Wisconsin Subscriber

Answer: Report 36200 (Introduction of catheter, aorta) and 75630 (Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation) on your claim.

Don’t miss: Code 75630 involves aortography, which includes placement of a catheter and radiological supervision and interpretation. Proper coding depends on the location of the catheter.

Code 75630 also describes an angiogram that the provider takes of the abdominal aorta and bilateral iliofemoral arteries to the lower extremities and includes radiological supervision and interpretation.

Radiology codes such as aortography are often components of other codes. For example, you may be able to append modifier 59 (Distinct procedural service) if the provider conducts an abdominal aortogram or 75630 at the same time as a diagnostic heart catheterization such as 93451 (Right heart catheterization including measurements of oxygen saturation and cardiac output, when performed) You must provide documentation that the radiology service was separately identifiable, medically necessary, and diagnostic.