On Demand: Basic Coding for Upper and Lower Extremity Angiography and Interventions-Presentation Slides

Presentation Slides

Pdf Summary

This 2025 MedAxiom presentation focuses on coding guidelines, procedures, and billing practices related to upper and lower extremity angiography and vascular interventions, including visceral vessels and renal denervation. Key topics include:

1. <strong>Moderate Sedation and Ultrasound Guidance:</strong> Definitions and CPT coding for moderate sedation requiring an independent observer (codes 99151-99153) and ultrasound guidance for vascular access (code 76937), highlighting documentation requirements.

2. <strong>Catheterization and Angiography Coding:</strong> Selective catheterization is preferred over non-selective, with coding based on arterial order and vascular family. Angiography codes include unilateral and bilateral extremity exams and selective vessel imaging (codes 75710, 75716, 75774).

3. <strong>Intervention Coding:</strong> Guidelines for angioplasty, stenting, atherectomy, and embolization in iliac, femoral/popliteal, tibial/peroneal, and visceral territories, including principles for coding multiple vessels, lesions crossing territories, and use of add-on codes. Examples feature catheter placements (codes 36245-36248), angioplasty (37246-37247), stent placement (37236-37237), atherectomy (Category III codes like 0238T), and embolization (codes 37241-37244).

4. <strong>Renal Sympathetic Denervation:</strong> Description and Category III coding (0338T, 0339T) for renal denervation procedures treating resistant hypertension.

5. <strong>Case Studies:</strong> Six detailed procedural case examples illustrate correct application of CPT codes for angiography, interventions, moderate sedation, and closure techniques, emphasizing accurate documentation.

6. <strong>2026 CPT Code Changes Preview:</strong> A draft crosswalk introduces new territorial coding for peripheral vascular interventions, distinguishing straightforward versus complex lesions and specifying lesions by vascular territory (iliac, femoral/popliteal, tibial/peroneal, inframalleolar).

7. <strong>Important Reminders:</strong> Proper documentation, communication with physicians, adherence to CPT and carrier-specific guidance, and awareness of coding changes are stressed to ensure accurate billing and compliance.

Disclaimers clarify the presentation’s informational purpose, non-guarantee of reimbursement, and encourage consulting experts and local payers for specific coding or reimbursement issues.

Keywords

MedAxiom 2025

angiography coding

vascular interventions

moderate sedation CPT codes

ultrasound guidance coding

catheterization coding

angioplasty and stenting codes

renal sympathetic denervation

CPT code changes 2026

vascular procedure documentation