CPT code 75774 is reported for  each additional vessel studied after the basic, initial study. It involves manipulating the catheter into additional second, third, or higher order vessels within a vascular family and performing injection of contrast and taking additional films. This code is an add-on code and cannot stand alone.

Case scenario 1 for addon CPT code 75774

Via femoral puncture the physician passes a catheter into the right subclavian artery and performs an arm arteriogram. This reveals probable stenosis of the distal radial artery, so the physician advances the catheter into the radial artery and performs an additional arteriogram.

36217 initial third order or more selective thoracic or brachiocephalic branch, within a vascular family

75710 Angiography, extremity, unilateral, radiological supervision and interpretation

+75774 Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure)

CPT code 75774 should not be assigned for additional imaging performed  with the catheter in the dame vessel as the original exam.

CPT code 75774 should not reported as part of diagnostic angiography of the extracranial and intracranial cervicocerebral vessels. It may be appropriate to report 75774 for diagnostic angiography of upper extremities and other vascular beds performed in the same session

The additonal arteriogram must be a medically necessary diagnostic study.

Multiple units of code 75774 may be reported if the physician performs addtional arteriograms in mutiple branch vessels. This seldom happens with arm arteriograms.

Case scenario 2 for CPT code 75774

Via femoral puncture the physician advances  a catheter into the left subclavian artery and performs an arm arteriogram. This reveals  stenosis of the distal vessels, so the physician  catheterizes the left radial and ulnar arteries and performs additonal arteriograms in each of these vessels.

In this case, no code is assigned for the first order catheter placement in the left subclavian artery, since it is on the pathway to the third order radial and ulnar arteries. Catheter placement in those vessels is reported with codes 36217 and 36218.

The intial arteriogram with the catheter in the subclavian artery is reported with code 75710, which represents a unilateral extemity arteriogram. The additional arteriograms in the radial and ulnar arteries are reported with 75774×2.