Radiology Coding Alert
Override the bundle in 75710 with 37224 and 37228
Question: Our physician did the following peripheral vessel angiograms:
Diagnostic right superficial femoral angiogram with runoff
Right popliteal percutaneous transluminal angioplasty (PTA) and angiography
Right posterior tibial artery PTA and angiography
These were done by using an antegrade approach for limb salvage. How can we report these procedures?
Utah Subscriber
Answer: For the right popliteal PTA and angiography, you should report 37224 (Revascularization, endovascular, open or percutaneous, femoral, popliteal artery[s], unilateral; with transluminal angioplasty) and for the right posterior tibial artery PTA and angiography, you should report 37228 (Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty).
Note: The descriptors for both 37224 and 37228 specify “initial vessel.” For these codes, “initial vessel” refers to an initial vessel in a territory (such as popliteal or tibial). Consequently, you can use two “initial” codes for the same encounter as long as each “initial” code applies to a different territory.
Radiological supervision is inclusive: Codes 37224 and 37228 include necessary catheterization and radiological supervision and interpretation, so you should not report separate codes for radiological interpretation and supervision, according to CPT® guidelines.
You can report the diagnostic femoral angiogram with runoff separately as long as the study was a true diagnostic study under CPT® guidelines. In other words, the femoral angiogram should be the initial diagnostic study and the interventional procedure wasn’t staged or planned based on another study. For a unilateral study from a catheter in the femoral artery, use 75710 (Angiography, extremity, unilateral, radiological supervision and interpretation) with modifier 26 (Professional component).
Watch the bundle: Correct Coding Initiative (CCI) edits bundle 75710 into both 37224 and 37228, so you’ll need to append a modifier to 75710 to override the edit. You can use modifier 59 (Distinct procedural service) or XU (Unusual non-overlapping service).
Related Articles
Radiology Coding Alert
- CCI 21.1:
Check These 3 New Coding Edits That Are Likely To Impact Your Practice
Check if modifiers can help you bypass a bundle, though this may not always apply. [...] - Imaging:
Basic Facts Help Make Your Way To Easy Reporting For Ultrasounds
Justify medical necessity to build rational claims; check if modifier 26 applies. Ultrasounds may be [...] - ICD-10 Coding:
Answer These Top 3 Questions To Assess Your Understanding Of Aortic Dissection
Use the fifth digit to designate site. You can take it easy. ICD-10 offers simple [...] - Verify Your Answers To The ICD-10 Coding Quiz
Check this one-to-one match for aortic dissection. Answer 1: The correct answer is option c, [...] - Reader Questions:
Differentiate Simple vs. Complex in Stereotactic Radiosurgery
Question: Our physician does stereotactic radiosurgery to treat a pineal tumor. How can we report for [...] - Reader Questions:
Submit Code 93880 for Carotid Doppler
Question: How can we report Doppler study for the carotid artery? New Jersey Subscriber Answer: You [...] - Reader Questions:
Override the bundle in 75710 with 37224 and 37228
Question: Our physician did the following peripheral vessel angiograms: Diagnostic right superficial femoral angiogram with runoff [...] - Reader Questions:
Earn For Contrast Injection with 27370
Question: Our physician assisted in a knee arthrography by injecting contrast to guide the knee arthrography. [...] - Reader Questions:
Avoid Modifier 26 When You Own X-Ray Equipment
Question: Our physician used X-ray equipment in the office to place the needle prior to [...] - You Be the Coder:
Confirm Contrast in MRA of Brain
Question: In a patient who reported for third nerve palsy, our physician did an MRA of [...]
