What specifically about the guidelines confuse you? Or is it applying the codes?
75625 = Aortogram. Cath placed in RCF (right common femoral) up to aorta and aortogram performed.
75630 = Aortogram with Bilateral run-offs; single cath position. Cath placed in LCF and tracked up to the aorta where Aortogram and complete bilateral run-off are performed.
75710 = Unilateral lower extremity (LE) run-off. Catheter placed in RCF then selectively placed in contralateral SFA (36247) with run-off (75710).
75716 = Bilateral extremity run-off. Abdominal aortogram (75625-26,59) for abdominal aortic aneurysm work-up and complete bilateral lower extremity run-off (75716-26,59) for claudication at the time of coronary angiography (93454-26).
75774 = Additional selective imaging after basic exam. RFA punctured cath placement at the renals for aortogram and complete run-off (36200, 75630-26). Followed by a selective cath placement to the LCF (left common femoral) (delete 36200, add 36246) for additional images at popliteal level (75774-26). Cath advanced further into popliteal artery (delete 36246, add 36247). Final codes: 36247, 75630-26, & 75774-26.
You wouldn't use 75774 with 75710.
As far as the guidelines go...in order to bill 75710, 75716, 75625, 75630 & 75774 you must meet the criteria set forth by AMA CPT.
1. There must not be a previous study done OR the decision to intervene and perform peripheral intervention is based on diagnostic study of angio's.
2. IF a prior study was done (there is no time line set forth) but is documented in the medical record:
A. The patient's condition since last study has changed
B. There is inadequate visulization of the anatomy\
C. There is a clinical change during the procedure that reqires new evaluation outside the target area of current intevention.
You may have to query your provider if he/she doesn't have solid documentation outlining medical necessity.
If you meet the criteria, you'll need to add a 59 on the angio codes, when applicable.
HTH
