Radiology Coding Alert

Pulmonary angiography is a diagnostic procedure used to identify pulmonary embolisms (PE), says Stacey Hall, RHIT, CPC, CCS-P, director of corporate coding for Medical Management Professionals Inc. Symptoms that may indicate the presence of potentially life-threatening PEs include shortness of breath (ICD-9 786.05 ), painful respiration (ICD-9 786.52 ), primary pulmonary hypertension (416.0), unspecified chronic cardiopulmonary disease (416.9) and cardiac arrest (427.5).

Once the condition is diagnosed, interventional radiologists treat the patient to restore proper blood flow. When the interventionalist has located the embolism, he will infuse a lytic agent to dissolve the blockage. This is reported with 37201 (Transcatheter therapy, infusion for thrombolysis other than coronary) and 75896 (Transcatheter therapy, infusion, any method [e.g., thrombolysis other than coronary], radiological supervision and interpretation).

The radiologist may also place an inferior vena cava (IVC) filter (e.g., Braun filter, Greenfield filter, "bird's nest" filter, etc.) below the point where the renal veins enter the IVC to prevent any emboli from entering the pulmonary artery. You should use 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]) with 75940 (Percutaneous placement of IVC filter, radiological supervision and interpretation). These transcatheter therapy codes may be reported in addition to the inferior vena cava imaging and catheter placement.