In interventional radiology coding, the main procedure is sometimes easy to code as compared to supervision and interpretation cpt code. Vascular procedure coding depends on selective and non-selective catheterization while studying arteries. When, we code for catheterization, we have a direct for the first, second and third order arteries. So, while coding catheterization we have no problem. But along with procedure codes, we have to code radiological supervision and interpretation codes, for the finding observed while performing the procedure. So, the main procedure which have more problem to code is abdominal aortogram with runoff cpt code.
Study of abdominal aortogram
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While studying abdominal aortogram, the catheter is placed in the abdominal aorta after taking an access through an artery. After the catheter reaches the aorta, the contrast medium is injected to take films to study the abdominal aorta. Now, when the catheter is reached to the abdominal aorta, the position of catheter final decides whether it is runoff or without runoff exam.
Abdominal aortogram without runoff cpt code
When the catheter reaches the abdominal aorta, the catheter take a final position or point of study. After reaching the point of study, the contrast medium is injected and the contrast flows through the aorta. Films are taken to find any abnormality in aorta. Now, when the contrast medium is injected from point of study, the study is done only about abdominal aorta. Further, the catheter is moved to another point of study, just at point when bifurcation of lower extremity take place. Now, again a contrast medium is injected to study the arteries of lower extremities. So, now conclusion is the contrast is injected at two points to study the abdominal aorta and bilateral lower extremity. Also, need to have the diagnostic finding documented about abdominal aorta and bilateral lower extremities.So, now if we have to code this scenario, the cpt codes will be 36200,75625,75716.
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36200– Catheter placement in aorta.
75625- abdominal aortogram performed through the catheter placed in aorta.
75716- bilateral lower extremity angiogram performed through the catheter placed in the aorta just above the bifurcation of lower extremities.
Abdominal aortogram with runoff cpt code
The whole procedure takes place as usual here also, the only difference is the catheter is at only one place. The catheter after reaching the point of study in aorta, the contrast medium is injected to study the abdominal aorta. Now, here the contrast flows from the abdominal aorta to the arteries of bilateral lower extremities as well. Since, the contrast flows from aorta to the both legs, the study is considered as runoff study. Also, need to check the diagnostic finding documented about abdominal aorta and bilateral lower extremities.
Now, when have to code this scenario, the cpt codes will be 36200, 75630.
75630- this runoff code includes abdominal aortogram + the angiography of bilateral lower extremities.
Hope, now you know when to code abdominal aortogram runoff cpt code. If you like the article do share it.