Diagnostic Angiogram and Aneurysm Coiling Procedures

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Question:

I heard at a seminar that diagnostic angiograms performed at the same operative session as an aneurysm coiling, 61624 cannot be billed. Is that true?

Answer:

No that is not exactly true. According to CPT, diagnostic angiograms performed at the time of an interventional procedure may be separately reported if:

  • No prior catheter-based angiographic study is available and a full diagnostic study is performed and the decision to intervene is based on the diagnostic study OR
  • A prior study is available but as documented in the medical record is that:

– The patients condition has changed since the prior study

– There is inadequate visualization of the anatomy and/or pathology on that study

– There is a clinic change during the procedure that requires a new evaluation outside the target area of intervention

One of these conditions should be documented in the operative note; ideally in the Indications for Procedure section of the procedure note. It must be clear that one of these conditions existed to justify a diagnostic study at the same time as an intervention (e.g., coiling).