Cardiology Coding Alert

Question: When may I report 75774?

Indiana Subscriber

Answer: In short, you may report +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation) when the provider performs an additional selective angiographic study within the same anatomic area after a basic angiographic study of the same anatomic territory.

Because 75774 is an add-on code, you must report it in addition to the code for the initial angiographic study.

Watch for: The descriptor specifies that the cardiologist must perform this additional study from a selective catheter position. In virtually all scenarios, one of two things must happen to graduate from being a non-selective catheterization to one that is selective:

1. the provider could manipulate the catheter through a fork in the arterial pathway while moving away from the aorta in the same vascular family as the access site, or

2. after entering the aorta, the provider could manipulate the catheter into a vascular family that is different from the one initially accessed.-

Example: A study requires imaging of the bilateral lower extremities (75716, Angiography, extremity, bilateral, radiological supervision and interpretation) from a catheter position in the lowest portion of the abdominal aorta. This study reveals an abnormal flow pattern in the contralateral leg at the knee level.

To more definitively clarify the defect, the doctor selectively catheterizes the contralateral superficial femoral artery (36247, Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family) and performs another study of the contralateral leg. Report the additional contralateral leg study with 75774 in addition to the basic study (75716).