General Surgery Coding Alert

Question: Our surgeon performed a diagnostic CT angiography with contrast for a patient with suspected fibroids, followed by a UFE to treat the condition by cutting off arterial blood flow to the tumor. How should we code this case?

Texas Subscriber

Answer: You should report the diagnostic imaging study as 74174 (Computed tomographic angiography, abdomen and pelvis, with contrast material[s], including noncontrast images, if performed, and image postprocessing). You should bill the Uterine Fibroid Embolization (UFE) as 37243 (Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction).

Caution: If the patient has had a prior imaging study with no significant change in her condition, the surgeon should not perform and bill the diagnostic angiography.

Remember that the 37243 service includes all radiological supervision and interpretation (RS&I), guidance, and imaging needed to complete the intervention. That means you should not additionally report a code such as 75894 (Transcatheter therapy, embolization, any method, radiological supervision and interpretation) or 75898 (Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis) for the procedure RS&I.