Radiology Coding Alert

Question: Which code would you use for a “shunt series” ranging from two to five views on different reports? I am considering code 75809, but I feel like that would be more involved than just a couple of X-rays, which is all that the provider documents.

Alabama Subscriber

Answer: A CPT^® Assistant (September 2008; Volume 18: Issue 9) article on code 75809 (Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation) states the following:

• “This code can be used for evaluation of a variety of similar and related nonvascular shunt catheters and devices, and requires the injection of contrast. Occasionally, evaluation for discontinuity is performed using plain radiography or CT imaging, without catheter contrast injection. In such cases, the service should be reported using appropriate radiography or CT codes describing which anatomical areas were imaged (eg, brain, neck, chest, and/or abdomen).”

As you can see, use of code 75809 requires the injection of contrast to evaluate various nonvascular shunt catheters and devices. Since the provider only performs a series of X-rays to view the respective shunts, you should follow by the CPT® Assistant instructions and only report X-ray codes for the various anatomical sites the provider images.