Radiology Coding Alert

Question: I have experience as a medical coder, but I’m new to radiology coding and I’m struggling with the following operative note. What are the correct codes for the procedures?

Operative Procedure:

1. Right femoral artery access under ultrasound guidance.

2. Infrarenal aortogram with iliofemoral runoff and interpretation.

3. Reposition of the catheter, with selective left superficial femoral arteriogram and interpretation.

4. Left common femoral artery atherectomy.

5. Left common femoral artery drug-coated balloon angioplasty with 7 x 80 mm drug-coated balloon (Medtronic). Pre-intervention totally occluded, post with 0 percent stenoses.

6. Post-treatment left common femoral artery selective arteriogram, with distal runoff and interpretation.

7. Close to the right femoral artery.

Wisconsin Subscriber

Answer: You’ll assign two CPT^® codes to report this procedure. First, you’ll assign 37225 (Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed) to report the angioplasty and atherectomy portions.

Next, you’ll assign 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation) to report the angiograms used during the operation. Since 75710 is an inherently unilateral procedure code, you’ll append it with LT (Left side) to indicate laterality. Additionally, you’ll need to append modifier 59 (Distinct procedural service) to 75710 to show it was separate from 37225.

In summary, you’ll report 37225 and 75710-LT-59 to report this operative encounter.