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Amazing guide for CPT code for Angiogram in Surgery

Basics about CPT code for Angiogram 

For percutaneous surgery, it is very important to code the angiography codes for studying the arteries or veins. In interventional radiology, we have many CPT codes for angiograms that are specific are each artery or vein. These Angiogram procedure codes are little different for breast biopsy CPT codes and the regular non-vascular Interventional procedure like nephrostogram, Cholangiogram, arthrocentesis etc. Since, these are used only for the vascular procedures it is very important to know the anatomy and physiology about blood vessels especially about arteries. Most of the CPT codes for angiogram are for arteries. Therefore, we will try to learn each CPT code for arteriogram or angiogram from head to lower extremity in this post.

angiography

CPT codes for Cerebral Angiogram

As we know from 2013, the most of the procedures or angiogram CPT codes have been bundled with the main surgery codes. The CPT codes ranging for 36221-36228 comprises of the Non-Selective and Selective Catheterization for Cerebral angiogram. These CPT codes include the supervision and interpretation for cerebral angiogram and hence should not to be coded separately. Therefore, for Cerebral angiogram we should not be worried, just code for the procedure performed and the respective angiogram, as internal carotid, external carotid or cervicocerebral arch angiogram will be included with that procedure code. These new bundled CPT code for Cerebral angiography (36221-36228) have made it easy coding upper extremity vascular coding. Effective January 1, 2013, the  CPT codes for angiography and radiological supervision and interpretation (RS&I) 75650, 75660, 75662, 75665, 75671, 75676, 75680, and 75685 for the carotid, cerebral, vertebral, and cervical arteries have been deleted because the work in these codes have been included or bundled in the code series (36221-36228).

36221 Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated RS&I, includes angiography of the cervicocerebral arch, when performed

36222 Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated RS&I, includes angiography of the cervicocerebral arch, when performed

36223 Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated RS&I, includes angiography of the extracranial carotid and cervicocerebral arch, when performed

36224 Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated RS&I, includes angiography of the extracranial carotid and cervicocerebral arch, when performed

36225 Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associate RS&I, includes angiography of the cervicocerebral arch, when performed

36226 Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated RS&I, includes angiography of the cervicocerebral arch, when performed

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 +36227 Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated RS&I (List separately in addition to code for primary procedure)
 (36227 should be reported in conjunction with 36222, 36223, or 36224)

+36228 Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated RS&I (ie, middle cerebral artery, posterior inferior cerebellar artery) (List separately in addition to code for primary procedure)

As you can see in the above codes, all these CPT codes include or bundled cerebral angiogram. Only, one CPT code is enough to code for upper extremity vascular exam.

CPT codes for Thoracic Angiogram

This angiogram is very rarely coded. The CPT code for Thoracic angiogram is 75605 and should be coded only when the document clearly supports for the thoracic angiogram. Most of the times we get confused, whether it is an arch angiogram or thoracic angiogram. So, do check the documentation to code thoracic angiogram CPT code 75605.

CPT code for Angiogram

CPT code for Abdominal Aortogram

This is very common code used with Catheterization of Aorta. Remember always there are two CPT codes used for Abdominal Aortogram, CPT code 75625 and 75630. The code 75625 is without runoff and code 75630 is with runoff. So, check the documentation, before coding these CPT codes. With my experience, whenever there is an aortogram study it is very common to find abdominal aortogram performed with peripheral angiogram with code 75710 and 75716. So, do check the documentation before using any of these angiogram or aortogram CPT codes.

CPT code for Spinal Angiogram

The CPT code used for Spinal Angiogram is 75706. This CPT code description includes “SELECTIVE” word in it. So, do remember for using this code, always check the tip of the position of catheter. The tip of the catheter should be in the spinal arteries to code this CPT code 75706.This Angiogram CPT code could not be used when the spinal arteries are studied by placing the catheter in different position.

CPT code for Visceral Angiogram

Visceral Arteries include mesenteric artery, splenic artery, hepatic artery, celiac artery etc. The CPT code used for visceral angiogram is 75726. This CPT code includes the abdominal aortogram or angiogram 75625. Therefore, do not code CPT code 75726 and 75725 together. The code description includes word “SELECTIVE” in it. Hence, should be coded only when the tip of the catheter is present in the visceral arteries.

CPT code for Pelvic Angiogram

Pelvic arteries include the branches of internal iliac artery (mnemonic). The branches of iliac artery comprises of iliolumbar artery, lateral sacral artery, vaginal artery, umbilical artery, gulteal artery, obturator artery, pudendal artery, inferior vesicle artery and middle rectal artery. The CPT code for Pelvic arteriogram or angiogram is 75736. This procedure code is also “SELECTIVE”. Hence, do check the tip of the catheter before coding CPT code 75736.

CPT code for Extremity or Peripheral Angiogram

These are very commonly used for Peripheral angiography. There are two CPT codes for extremity angiogram, code 75710 and 75716. These are mostly used with Non-selective study of abdominal aortogram. The coded 75710 is used for unilateral and 75716 are used for bilateral study of extremity angiogram. Do use the LT and RT modifier with these angiography CPT codes. These are non-selective CPT codes and hence can be coded even if the extremities are studied by placing the catheter in the aorta.