ZHealth Publishing Coding Q&A
by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Libman Education is proud to offer ZHealth Publishing’s broad range of coding products to assist both the novice and the seasoned coder to become experts at coding and charging for complex procedures in Interventional Radiology, Interventional Cardiology, Vascular/Endovascular Surgery, and Diagnostic Radiology. Periodically, ZHealth Publishing experts offer general recommendations in response to specific customer inquiries.
Question: Peripheral Angiography with a Cardiac Cath
Left heart catheterization is ordered for a patient with unstable angina. The Op report states that the patient also has a small ulcer on the foot, a history of atherectomy of the SFA, and reassuring ABI. Catheterization is performed via a right radial artery access. Subsequently, the catheter is moved down to right common femoral artery where runoff of the right leg with digital subtraction at 2 levels is performed. CFA is normal and arthrectomy site is patent. Would this be coded 93458, 36247, 75710?
Yes, you can code the diagnostic angiography of the leg at the same session as the cardiac catheterization when there is a clinical indication for the peripheral angiogram. From the radial approach, the catheter placement in the common femoral artery is 36246, imaging is 75710 and these will need -59 modifiers due to NCCI edits (these procedures are separate and distinct from the heart cath).
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David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC, is the founder and President of ZHealth Publishing and the primary author and editor of each ZHealth publication. Dr. Z practiced as an interventional radiologist for fourteen years and has over twenty years experience as a coding reviewer and coding expert. He is Board Certified in Radiology with the Certification of Added Qualification in Interventional Radiology (1995, 2005). Dr. Z has functioned as an independent interventional radiology, vascular surgery, and cardiovascular coding consultant to a variety of physician groups and hospital providers across the country, and he has served as an instructor in over 200 coding seminars. Dr. Z was on the AAPC National Advisory Board from 2005-2009. A graduate of Oregon State University and Oregon State Sciences University School of Medicine, Dr. Z completed his internship, radiology residency, and interventional radiology fellowship at Emory University Hospital in Atlanta, GA.