Radiology Coding Alert

Question: Our radiologist performed a visceral angiogram and did selective injections of both the superior mesenteric arteries (SMA) and the inferior mesenteric arteries (IMA). Do I bill the visceral angiogram with 75726, and report 75774 for the second mesenteric? To me, this service seems to indicate that the second mesenteric is an additional vessel studied after the basic exam of the first mesenteric artery. Am I correct?

Oregon Subscriber

Answer: No. Because the SMA and IMA are separate vascular families, 75726 (angiography, visceral, selective or supraselective, [with or without flush aortogram], radiological supervision and interpretation) would be coded twice, along with two first-order selective catheterization codes (36245, selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family).

In a case like this, 75774 (angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation) would describe a more selective angiogram of a branch, or the SMA or IMA after the less selective angiogram was performed. Code 75774 would be used, for instance, if the SMA is selected and imaged, followed by right colic artery (RCA) being supraselected and imaged. In this case, the SMA would be considered basic, while the RCA is "additional beyond the basic."


"You be the Coder" and "Reader Questions" were answered by Donna Richmond, CPC, radiology coding specialist with Acadiana Computer Systems Inc., a medical billing management company based in Lafayette, La., which serves more than 200 radiologists, pathologists and anesthesiologists.