Cardiology Coding Alert

Question: Can I bill for any "runoff" imaging services when my cardiologist performs a femoral study?

Kentucky Subscriber

Answer: No, you should not report any additional or different code for a femoral study with or without runoff. As long as the cardiologist does not move the catheter (meaning the MD positions the cath once and performs all of the studies from the femoral artery and downstream from that position), you should include all of the imaging in the appropriate angiography code.

You can report femoral angiograms with a few different codes depending on the study's content. If the physician did only a lower extremity study, you would report 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation). If the physician selectively injects the femoral artery after a basic study (such as 75716, Angiography, extremity, bilateral, radiological supervision and interpretation), your code is +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation [list separately in addition to code for primary procedure]).

Impact: You should report the imaging code according to catheter position. For instance, you could report the imaging with 75710 (one extremity), 75716 (both extremities) or 75774 (additional selective after basic study), depending on the procedure note.

Keep in mind, however, you cannot separately report any subsequent studies the physician performs from the same catheter position (such as a complete runoff study). Indeed, you won't find any other "runoff" codes other than 75630 (Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation).