Cardiology Question for the Week of September 7, 2020

Question:

If instead, selective renal angiography is performed, can I submit selective catheterization codes (i.e., 36245) plus the supervision and interpretation (i.e., S&I) code for this procedure plus the cardiac cath code(s)?

Answer:

Several years ago, the AMA deleted the S&I codes that described selective renal angiography (codes 75722 and 75724) and replaced them with four “bundled” options (36251–36254) that include several portions of the study. Included in these codes are the vascular access, fluoroscopy, catheter placement, flush aortography, the S&I code itself, pressures, and image-post processing. These codes also include any accessory renal arteries that may be engaged, injected, and imaged. An easy way to separate and understand how these four choices may be used is as follows. Codes 36251 and 36252 include first-order selective catheterization and imaging from these first-order placements. The codes are for unilateral (36251) or bilateral (36252) procedures. Codes 36253 and 36254 include selective catheterization of a second-order or higher. The codes are for unilateral second + order (36253) or bilateral second + order of selectivity studies.

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