Wiki Atherectomy w/LE angio, aortogram and selective angio of the LT anterior tibial.

[jewlz0879]

Insurance is denying CPT 75625, 75716 & 75774 as inclusive to the interventions. We used modifiers, however, UHC is still denying these codes. There is no previous diagnostic study on file, as a result of the findings, atherectomies were performed.

I am seeking help with the documentation. The results support the codes but I feel the documentation is lacking; it's not entirely clear. Can we give credit for codes based on the findings? It is my understanding the cath placements should support the findings.

• I do not see RT LE angio other than in the findings.
• Also, this does not make sense to me; I feel it could be a typo: "An aortogram was performed in the left common iliac artery was then selected up and over the aortic bifurcation."

It's important to note the physicians do their own coding.

Based on the documentation, would you give credit for CPT code: 75625; 75716-XU

 

[Jim Pawloski]

There isn't any documentation of the renal arteries which is needed for a full and complete abdominal aortogram. So, no to 75625. Also, there is no documentation of catheter movement during the diagnostic portion of the exam, so no to 75774. Depending on the third-party payer, you may have to use -59 for 75716
HTH,
Jim Pawloski, CIRCC