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PERIPHERAL CODING

Liz Posted Tue 02nd of April, 2013 14:28:47 PM

Right femaoral artery access, selective catheter placement into left subclavian artery, angiogram of left subclavian artery, balloon angioplasty of left subclavian artery, stent introduction and stent deployment to left subclavian artery and visceral angiogram were done. Is the following code selection correct: 36215 35475 37205 75960-26 75710-26 75726-26

SuperCoder Answered Tue 02nd of April, 2013 22:05:27 PM

To determine the proper codes, you’ll need to review the documentation to see if the left subclavian angiography (75710-26) and visceral angiography (75726-26) were true diagnostic studies, as defined by CPT, and also check for where the catheter was placed for the visceral angiography for proper coding.

Note that CCI bundles both 75710 and 75726 into stent codes 37205/75960, so you would need to append modifier 59 to the angiography codes if they are reportable diagnostic services.

Bottom line, if the angiography was performed simply for roadmapping for an already planned interventional service, then you shouldn’t report the angiography separately.

You should report only the stent services if the physician’s intent going into the surgery was to place the stent. If angioplasty was the intended treatment, but it failed, leading to stent placement, then documentation needs to be very clear on that point. You may be able to report both services in that case using the codes you listed.

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