Radiology Coding Alert

Question: The provider performed a computed tomographic angiography (CTA) abdominal aorta with runoff in addition to a CTA of the left lower extremity. Does an LT modifier on the CTA extremity suffice? Should I also use modifier 59?

Wisconsin Subscriber

Answer: Despite the fact that two separate exams were ordered and performed, you should not code these two procedures together under any circumstance. A simple Correct Coding Initiative (CCI) check will show that 75635 (Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing) and 73706 (Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing) are mutually exclusive procedures.

Additionally, the CCI Policy Manual explicitly states the following regarding the combination of the 73706 and 75635:

• "CPT^® code 75635 describes computed tomographic angiography of the abdominal aorta and bilateral iliofemoral lower extremity runoff. This code includes the services described by CPT^® codes 73706 and 74175. CPT^® codes 73706 and 74175 shall not be reported with CPT^® code 75635 for the same patient encounter. CPT^® code 73706 plus » CPT^® code 74175 shall not be reported in lieu of CPT^® code 75635."

Since 73706 is the column 2 code, you will only include code 75635 in this example.