Question:

When coding for renal angiography, do you have any tips or guidance for reporting?

Answer:

When studying two or more vascular families, code each separately. Code to the highest order of selectivity within each vascular family. Bronchial/intercostal arteries are considered to be thoracic/brachiocephalic arteries. When imaging more than one second- or third-order vessel in a single vascular family, code to the highest order, then recognize additional second- or third-order vessels within that family with code 36248. Selective renal arteriography is coded with complete codes describing unilateral or bilateral first-order studies and unilateral or bilateral second-order or higher studies. Each code includes catheter placement(s) and radiological supervision and interpretation. Accessory renal arteries are included and not coded separately. Flush aortography (75625) is also included in 36251–36254 and not coded separately. Code 36251 is a unilateral first-order exam. The catheter is maneuvered out of the aorta into the main renal artery for diagnostic angiography. An accessory artery also may be selected and imaged. Branches of the main renal artery may be imaged but not selected. If both left and right main renal arteries are selected and imaged, assign code 36252. If one or more accessory arteries are selected, they are included in the procedure, and no additional code would be assigned. Do not code 36251 twice (36251-50 or 36251-RT and 36251-LT) instead of 36252 when bilateral renal angiography is performed.

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