Thrombectomy and Follow-up Angiogram Coding

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Question:

We billed percutaneous thrombectomy (37184) for an intracranial clot and an associated completion angiogram (75898) but payers keep denying the angiogram. Is there a way to get this paid?

Answer:

Per CPT rules, percutaneous thrombectomy, 37184, includes all fluoroscopic guidance, including completion angiograms. Therefore, 75898 should not be separately reported.

CPT Changes: An Insider’s View 2006 states the following:
“Unlike most transcatheter procedures, there are not separate radiological supervision and interpretation codes to report imaging services provided in conjunction with mechanical thrombectomy. Arteriography and/or venography related to guidance and monitoring of the mechanical thrombectomy and completion study(s) for this service performed on the same day are included in codes 37184-37188.”

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