Ask Dr. Z

"Occlusion of midportion of SFA with reconstitution to the below-knee popliteal artery.4-0 spider wire was deployed into the distal popliteal artery. Area was predilated. Atherectomy was performed in the occluded area.Multiple cuts were performed in multiple areas.2 balloons were inflated to nominal pressure per protocol. Excellent results were obtained.Spider wire had embolic debris contained within.This was removed in the usual manner. A runnoff was performed following removal of spider wire and was found to be unchanged compared to pre-intervention." Provider is asking to bill the angio due to tibials being imaged post atherectomy to evaluate embolic debris, stating a different territory is selected, spider wire removed, and catheter remains in place, and that it is independent of the procedure performed proximally in a different territory. Is this considered a true diagnostic angiogram? We feel it is not separately billable (pre-procedure aorta/leg runoff was done and is being captured). Please kindly advise on allowance to bill post procedure angio in this case.