Ask Dr. Z

I have a scenario that is frequently encountered in our IR department. A patient with a prior diagnostic lower extremity angio (75716) comes in for revascularization. Due to the occlusion the guidewire is unable to cross and any revascularization attempts are aborted. All that is performed is another angiography. Based on the coding rules, I cannot capture another diagnostic exam. However, since the plan was for intervention, can a PTA be charged with a -74 modifier or should the diagnostic 75716/75710 be charged with a -59 or is there a better option in this case? I am inclined to think that if the doctor is only able to get a wire in then 75716/75710-59 should only be billed, however I still question if that is appropriate. Thank you for your help.