January 2018 Q & A

Question: Peripheral Angiography with a Cardiac Cath

Left heart catheterization is ordered for a patient with unstable angina. The Op report states that the patient also has a small ulcer on the foot, a history of atherectomy of the SFA, and reassuring ABI. Catheterization is performed via a right radial artery access. Subsequently, the catheter is moved down to right common femoral artery where runoff of the right leg with digital subtraction at 2 levels is performed. CFA is normal and arthrectomy site is patent. Would this be coded 93458, 36247, 75710?

Answer:

Yes, you can code the diagnostic angiography of the leg at the same session as the cardiac catheterization when there is a clinical indication for the peripheral angiogram. From the radial approach, the catheter placement in the common femoral artery is 36246, imaging is 75710 and these will need -59 modifiers due to NCCI edits (these procedures are separate and distinct from the heart cath).