Diagnostic Angiograms

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December 13, 2012

Question:

I heard at a seminar that diagnostic angiograms performed at the same operative session as a stent or angioplasty can never 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:

ο The patients condition has changed since the prior study

ο There is inadequate visualization of the anatomy and/or pathology

ο 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 indications section. It must be clear that one of these conditions existed to justify a diagnostic study at the same time as an intervention.