Make the Right Selections in Interventional Angiography Coding
Published on Sun Sep 01, 2002
New research on abdominal aortography in conjunction with lower extremity angiography reported by the Mayo Clinic in Rochester, Minn., is prodding interven-tional radiologists to recommend aortographic procedures more frequently to patients at risk for cardiovascular diseases.
As a result, IR coders can expect to be grappling with the specifics of abdominal aortography more often. A firm grasp on the differences between 75630 (Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological S&I) and the associated CPT 75625 (Aortography, abdominal, serialography, radiological S&I) and 75716 (Angiography, extremity, bilateral, radiological S&I) is the hinge upon which accurate reimbursement depends.Angiography, the family of procedures that includes aortography, refers to the process of injecting blood vessels with contrast material that shows up on X-rays. The procedure may be only for diagnostic purposes or it may be used to guide and monitor treatment, in which case it is known as interventional angiography. This technique can be used to look at arteries in many areas of the body; when the aorta is injected, the procedure is called an aortography.75630 Versus 75625/75716According to C.J. Wolf, MD, CPC, CPC-H, senior consultant at Intermountain Health Care in Salt Lake City, CPT Code 75630 should be reported when the abdominal aorta and the lower extremities iliofemoral studies are studied via a single catheter position and single contrast injection. Generally, the way the procedure works is that the physician will insert the catheter and advance it into the proximal aorta; at that point, he will inject the contrast and obtain radiographic images that will later be interpreted. This study provides information about the distal abdominal aorta and the lower extremity arteries in an examination commonly referred to as a un-off"" angiogram (e.g. an examination in which the contrast outlines the run-off arteries of the lower abdominal aorta). The key to this procedure Wolf says is that it is performed via a single catheter position without regard to the number of contrast injections.
This procedure is commonly referred to as a nonselective examination of the pelvic arteries and lower extremities says Jeff Fulkerson BA CPC coding specialist at the Emory Clinic in Atlanta. In addition 75630 is used to describe a focused angiogram that is restricted to studying the abdominal aorta the pelvic vessels and the proximal lower extremity arteries as is often performed in patients with abdominal aortic aneurysms without symptoms of claudication or lower extremity ischemia and normal noninvasive vascular tests.Coding scenarios may get more complicated Wolf says if as frequently occurs after positioning the catheter in the proximal aorta the physician brings it back to the bifurcation of the abdominal aorta i.e. where the aorta splits into the common iliacs. The physician may then reposition the catheter [...]
