Wiki Neurointerventional 75774

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MsAnna

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Often we will do a "standard" diagnostic angio with bilateral 36224, 36226 and 36227. On ocassion the MD with also do the thyrocervical trunk-is it not correct to use the 75774 as it is a different vascular bed? We get denied due to there not being a parent code that the add on code 75774 can attach to. I'm confused. Any thoughts?

Anna
 
Hi. I just had this same issue and queried Dr. Z on it. It looks like this rejection is going to be an issue until 2015, when the changes take effect.

Below is the reply I got from him.

With release of the 2015 CPT Codebook yesterday, new information regarding the coding for these additional selective injections has been given. Specifically if, after 36225 or 36226, additional selections of branches off the subclavian are made to evaluate additional supply to the vertebral distribution or shoulder girdle region, use code 36218 for the selections and 75774 for the additional imaging. Due to parenthetical issues currently, you probably will hit add-on code edits with payers until 2015 when the new parentheticals are recognized. You should not use code 36228 here, as that code is for additional intracranial selections that are more selective than the vertebral or ICA selection. -Dr. Z
 
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