Ask Dr. Z

A gray zone in my opinion. They definitely did not see enough to call this a bilateral lower extremity angiogram during a heart cath in my opinion. G0278 changed from iliac angiography to iliofemoral angiography at time of heart cath a year or two ago to prevent coding 75716 for obliques of the pelvis, so the proximal SFA and profunda femoral arteries are now clearly included in G0278 during a heart cath. Personally, if done during a heart cath and the catheter hooks the contralateral common iliac to visualize the iliofemoral on that side as a screening tool, then pull back into the ipsilateral for the same, I still just code G0278 and ignore the catheter placement. I suppose to be exacting per the codes, one should consider 36245-59, 75710-59 and G0278 for the ipsilateral side, however I think that 75710 is a zero edit with G0278 (so can’t be billed anyways) and the intent of the screening code G0278 is just that, screening. IF they look all the way down past the knees on both sides, then I switch to 75716-59. I remain conservative on these. Dr.z