Cardiology Coding Alert

Question: What details should the cardiologist include in the documentation for us to correctly bill G0278?

Ohio Subscriber

Answer: To understand what should be in the documentation for G0278 (Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation [List separately in addition to primary procedure]), let's look more closely at this code.

According to the code's descriptor, the different components the cardiologist needs to include in the documentation are:

• Iliac and/or femoral artery angiography
• Non-selective
• Bilateral or ipsilateral to catheter insertion
• Performed at the same time as cardiac catheter­ization and/or coronary angiography.

When you report G0278, the code includes:

• Positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery
• Injection of dye
• Production of permanent images, and
• Radiologic supervision and interpretation
• List separately in addition to primary procedure.

You should not use G0278 for routine standard protocol femoral injections prior to the decision of a closure procedure, according to Christina Neighbors, MA, CPC, CCC, Coding Quality Auditor for Conifer Health Solutions, Coding Quality & Education Department, and member of AAPC's Certified Cardiology Coder steering committee.

"Some physicians will perform an injection prior to the placement of a closure device, implant a closure device, or determine sutures are the best option for the patient," Neighbors says. "When this is performed, do not code G0278."

Medical necessity must be warranted to code G0278, Neighbors adds.

Caution: Code G0278 is not warranted for guiding purposes, road mapping, or follow-up injections to check previous interventional procedures, according to Neighbors.

It's not often you'd code G0278, and if the frequency has increased or you're always coding this procedure on every patient, clarify if this procedure is the physician's procedure standard protocol, Neighbors says.

Remember: Since G0278 is an add-on code, you must report it with the appropriate primary cardiac catheterization or coronary angiography code.