Table of Contents

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.

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.

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.

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.

36251 – Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral

36252 – Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral

36253 – Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral

36254 – Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral

75726 – Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation

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

Hope, now you know when to code abdominal aortogram runoff cpt code. If you like the article do share it.