Cardiology Coding Alert

Answer: For the selective catheterization of the left common iliac artery, report 36245 (Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family) and append modifier -LT (Left side) to indicate that the procedure was on the left side.

And if the documentation supports the supervision and interpretation (S&I) of the catheterization, you should report 75710-26 (Angiography, extremity, unilateral, radiological supervision and interpretation; professional component).

Because the angiogram indicated a stenosis in the left common iliac artery, the physician performed percutaneous transluminal angioplasty (PTA), also known as a balloon angioplasty, as the therapeutic intervention.You should report this procedure with 35473 (Transluminal balloon angioplasty, percutaneous; iliac). Remember to append modifier -59 (Distinct procedural service) to the diagnostic portion of this study (36245-LT-59) to indicate that this is a separate and distinct procedure from the PTA.

You should report 35473 only once per noncoronary vessel. If the procedure involves unusual services, such as when the physician uses multiple balloons to open up the vessel, you would append modifier -22 (Unusual procedural services) to 35473. Be sure to include in your documentation for modifier -22 specific information explaining why this procedure was unusual. For instance, you might include descriptions of extensive time (document specifically how much time), use of equipment, or anatomical complications or patient instability.