Candy Posted Fri 29th of March, 2013 01:37:56 AM
Selective Lt common iliac artery and Lt common femoral, Lt superficial femoral artery angiogram. PTA of Lt superficial artery "37224". Is this the only billable code?
SuperCoder Answered Mon 01st of April, 2013 21:12:11 PM
The answer depends on whether the angiography is truly diagnostic according to CPT standards (separately reportable) or whether it was required for (and therefore included in) an already planned PTA (37224).
CPT guidelines include this quote about what the code includes:
“These lower extremity endovascular revascularization codes all include the work of accessing and selectively catheterizing the vessel, traversing the lesion, radiological supervision and interpretation directly related to the intervention(s) performed, embolic protection if used, closure of the arteriotomy by pressure and application of an arterial closure device or standard closure of the puncture by suture, and imaging performed to document completion of the intervention in addition to the intervention(s) performed.”
Catheterization beyond that required for the PTA is also separately reportable, according to CPT Assistant (Oct. 2011), which includes this exception: “Exception 2: A diagnostic study is performed via the same access site but requires a higher level of selectivity than is required for the intervention. In this case, the higher-level catheterization is reported in addition to the intervention with modifier 59 appended to signify that the higher degree of selectivity was not part of the work of the intervention.”
These AMA slides are a helpful resource: http://www.ama-assn.org/resources/doc/cpt/vascular.pdf