CPT Codes for Peripheral Angiography / Angiogram

An angiogram or angiography is a common procedure that uses X-ray imaging to examine the blood vessels in your heart, such as an artery or vein. This test is used to determine whether there is any restriction or abnormality in blood flow to the heart. Most angiographic procedures are typically performed in the extremities or peripheral regions to diagnose peripheral vascular disease. These procedures necessitate adequate documentation, which medical coding companies that serve medical professionals effectively provide.

Why Angiography is Performed?

Angiograms are a type of heart (cardiac) catheterization that can be used to diagnose and treat heart and blood vessel conditions. Cardiac catheterization is most commonly used to examine the coronary arteries because disease in these arteries is the most common cause of heart attack, angina, and heart failure. Furthermore, this procedure may reveal the presence of other conditions such as left artery enlargement, ventricular aneurysms (abnormal dilation of a blood vessel), aortic valve narrowing, and septal defects that allow an abnormal flow of blood from one side of the heart to the other. Coronary angiography is performed under local anesthesia and intravenous sedation, and it is generally not uncomfortable. 

Angiography Procedure – CPT Codes

The Current Procedural Terminology (CPT) codes for peripheral angiography differ from the arteries under study.

CPT Codes for Peripheral Angiography for Upper and Lower Extremities

The extremities are the most frequently studied sites during interventional radiology medical coding. Lower extremities are typically studied while an aortogram is performed without a runoff. The CPT codes for peripheral angiograms will differ depending on whether the upper and lower extremities are unilateral or bilateral. In addition, aortogram coding will be performed in order to study the aorta.

Let's take a look at some of the codes used to code aortograms and extremity angiography -

75625– Aortogram without runoff, abdominal, radiology supervision and interpretation

75630– Aortogram with runoff, abdominal + bilateral lower extremity, catheter, radiology supervision and interpretation

75710– Angiography, extremity, unilateral, radiology supervision, and interpretation

75716– Angiography, extremity, bilateral, radiology supervision, and interpretation

Aortograms are commonly used in peripheral angiography. Because the aorta is the main artery from which the arteries of the lower extremities emerge, when a catheter is placed in the aorta and contrast dye is injected, the dye flows into the lower extremities. This aids in studying the aortogram and lower extremities simultaneously. As a result, coding for both an aortogram and a peripheral angiography is done concurrently - using code 75630.

CPT Codes for Angiography

75635 – Computed tomographic angiography, abdominal aorta, and bilateral iliofemoral lower extremity runoff, with contrast material, including non-contrast images, if performed, and image post-processing

75658 – Angiography, brachial, retrograde, radiological supervision, and interpretation

75705 – Angiography, spinal, selective, radiological supervision, and interpretation

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

75731 – Angiography, adrenal, unilateral, selective, radiological supervision, and interpretation

75733 – Angiography, adrenal, bilateral, selective, radiological supervision and interpretation

75736 – Angiography, pelvic, selective or supraselective, radiological supervision and interpretation

75741 – Angiography, pulmonary, unilateral, selective, radiological supervision, and interpretation

75743 – Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation

75746 – Angiography, pulmonary, by a nonselective catheter or venous injection, radiological supervision and interpretation

Following a basic examination, another CPT code - 75774 is used for supervision and interpretation when more than one artery from the same vascular family is studied. This is an add-on code that can be used multiple times.

Other Related Codes

There are CPT codes for angioplasty and stent placement that usually include angiography.

CPT Codes for Angioplasty

36902 – Introduction of needle and/or catheter, dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture and catheter placement, injection of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation, and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

36903 – Introduction of needle and/or catheter, dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture and catheter placement, injection of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation, and image documentation and report; with the transcatheter placement of an intravascular stent, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

36904 – Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection

36905 – Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

36906 – Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty

36907 – Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)

36908 – Transcatheter placement of an intravascular stent, central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment

36909 – Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention

37246 – Transluminal balloon angioplasty (except lower extremity artery for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery

37247 – Transluminal balloon angioplasty (except lower extremity artery for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery (List separately in addition to code for primary procedure)

37248 – Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein

37249 – Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure)

CPT Codes for Stent Placement

37221 – Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement, includes angioplasty within the same vessel, when performed

37223 – Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

37226 – Revascularization, endovascular, open or percutaneous, femoral/popliteal artery, unilateral; with transluminal stent placement, includes angioplasty within the same vessel when performed

37230 – Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, initial vessel; with transluminal stent placement, includes angioplasty within the same vessel when performed

37234 – Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

37236 – Transcatheter placement of an intravascular stent (except lower extremity artery for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery

37237 – Transcatheter placement of an intravascular stent (except lower extremity artery for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure)

37238 – Transcatheter placement of an intravascular stent, open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein

37239 – Transcatheter placement of an intravascular stent, open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (List separately in addition to code for primary procedure)

Healthcare providers and medical coders are required to have the knowledge and expertise required to code separate procedures accurately and avoid claim denials and delayed payments. A reliable medical billing and coding company can help tackle all kinds of processes related to coding separate procedures.