Radiology Coding Alert

Question: Is digital roadmapping considered billable as angiography? The report for PTA reads in part: "... Using digital roadmapping techniques and a combination of a 0.035 glide wire and 5F Kumpe catheter, the segmental occlusions within the distal left superficial femoral artery and the left suprageniculate popliteal artery were traversed. The glide wire was exchanged for a 0.014-inch iron man wire, and the Kumpe catheter removed. Subsequently, using digital roadmappping techniques, serial balloon dilatations were performed."

Would it be appropriate to bill 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation)? The impression reports occlusions in the SFA and popliteal. The remainder of the impression reports post-PTA, which I thought would not support an angiography procedure code.

Ohio Subscriber

Answer: The instructions from the SIR (formerly SCVIR) guidelines state that angiography for guidance and documentation inherent to a normal, uncomplicated angioplasty is included in the angioplasty. You should bill the S&I code for the angioplasty, which, by definition, includes all roadmapping angiography as well as the completion angiography. Full diagnostic angiography performed on the same date of service is separately coded and billed, however.

Reader Questions and You Be the Coder were answered by Gary Dorfman, MD, FACR, SIR, president of Health Care Value Systems in North Kingstown, R.I.; and Cindy Parman, CPC, CPC-H, co-owner of Coding Strategies Inc., an Atlanta-based firm.