Basic about Abdominal aortogram CPT code 75630 & 75625
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. Coding for vascular catherization procedures is based on the selection of the first, second or third order arteries. Hence, here if you have vascular family (Appendix L) chart in CPT code book, you can easily find the correct code for catheter access. Abdominal aortography CPT ( 75625 & 75630) code is one the most discussed procedure in vascular procedure coding.
Coding catheterization has less 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.
Procedure for abdominal aortogram cpt code with or without runoff
While studying abdominal aortogram, the catheter is placed in the abdominal aorta after taking an access through an artery. The most common access is via Femoral artery of lower extremity. After the catheter reaches the aorta, the contrast medium is injected to take films to study the abdominal aorta. When the catheter is in aorta, we have to check movement of catheter and the contrast injection for the study of aortography. Now, when the catheter is reached to the abdominal aorta, the position of catheter final decides whether it is runoff or without runoff exam.
Read also: Best coding tips for CPT code for Angiogram Procedures
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.
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.
Read also: Coding tips for CPT codes for Stent and Angioplasty procedures
Pre service for Abdominal aortography CPT codes
Based on the patient’s symptoms, signs, physical findings, and any preprocedural studies, determine the area of potential disease within the aorta or iliacs. Ensure full visualization of the total region of the potentially affected aortic segment using angiographic imaging in the interventional suite. Give consideration to the total length of expected imaging, the body habitus, limitation on movement due to underlying conditions, and positioning in order to ensure the best imaging of the abdominal aorta.
In addition to assessing the affected limb(s), ensure that imaging equipment can be rotated to provide complete imaging from multiple angles prior to patient positioning. Discuss the risks due to the exposure to radiation and use of contrast dye or other potential imaging modality (eg, carbon dioxide) with the patient and family. Discuss the equipment being used, the close proximity of the image intensifier and potential for claustrophobia, prolonged immobility, and repositioning to ensure optimal imaging for interpretation.
Intraservice for Abdominal aortography CPT codes
Use X ray to determine the best and safest access site for catheter positioning and contrast imaging. This requires static X-ray visualization of access site and anatomic landmarks to ensure direct anterior access to the access vessel. Upon access, multiple imaging angles are required to ensure complete visualization of the vasculature because this is a 2D representation of a 3D object. Due to the size and caliber of the abdominal aorta, use power injection for contrast administration for angiography. Communicate and verify total dosage and dilution of contrast along with injection rate and pressure for injection. Perform visualization of angiography of the abdominal aorta.
During angiographic interpretation, different angles are required due to the course of the vasculature as well as interference from overlapping bowel and gas, other vessels, and bony prominences. This requires prolonged visualization and interpretation due to multiple images. Use magnified imaging, as necessary, for best visualization of potential vascular lesions as well as reformatting pixilation due to movement. Visualization of the vasculature above and below the area of potential disease is imperative to determine the best treatment modality and to ensure iatrogenic injury (wire manipulation, embolization) has not occurred beyond the location of disease, as well as to assess all levels of disease.
Abdominal aortography with lower extremity 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, you need to check the diagnostic finding documented about abdominal aorta and bilateral lower extremities. Without finding of lower extremity arteries coder should not report 75630 cpt code.
Now, when have to code this scenario, the cpt codes will be 36200, 75630.
75630-Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation
This runoff code includes abdominal aortogram + the angiography/angiogram of bilateral lower extremities.
Read also: Best coding guide for vascular access Ultrasound Guidance CPT code 76937
CPT codes which bundle abdominal aortogram runoff CPT code 75630
Many procedure codes now bundled the abdominal aortography CPT code. Do not bill or separately runnoff cpt code when it is included or bundled in main procedure code. Below is the list of procedure code which bundled abdominal aortogram runoff procedure code.
ICD 10 PCS code for Abdominal aortogram runoff cpt code
B41D1ZZ Fluoroscopy of Aorta and Bilateral Lower Extremity Arteries using Low Osmolar Contrast
Section B Imaging
Body System 4 Lower Arteries
Type 1 Fluoroscopy: Single plane or bi-plane real time display of an image developed from the capture of external ionizing radiation on a fluorescent screen. The image may also be stored by either digital or analog means
Body Part D Aorta and Bilateral Lower Extremity
Contrast 1 Low Osmolar
Qualifier Z None
Qualifier Z None
Hope, now you know when to code abdominal aortogram runoff cpt code. If you like the article do share it.