Neurosurgery Coding Alert

Question: Can we bill diagnostic angiograms done during the same operative session as an aneurysm coiling which we report with 61624 (Transcatheter permanent occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method; central nervous system [intracranial, spinal cord])?

Florida Subscriber

Answer: Your surgeon does the aneurysm coiling as an intervention. According to CPT®, diagnostic angiograms performed at the time of an interventional procedure may be separately reported if no prior catheter-based angiographic study is available, a full diagnostic study is performed, and the decision for intervention is based on the diagnostic study OR a prior study is available but, as documented in the medical record, the patient's condition has changed since the prior study, there is inadequate visualization of the anatomy and/or pathology on that study, or there is a clinic change during the procedure that requires a new evaluation outside the target area of intervention. Make sure your surgeon documents these conditions in the operative note and these justify the diagnostic angiogram at the same time as the intervention.