Ask Dr. Z

Dr. Z, I am having a bit of a dilemma over a procedure that was done in our IR lab. The patient presented with bleeding to the abdominal wall post op hernia repair. The radiologist did a distal aorta and bilateral iliac angiogram. He then selected the lt internal iliac ( to"confirm its position"). He then selectively catheterizes a branch of the lt inferior epigastric and proceeds to embolization. No mention of an angiogram for the internal iliac. He does perform an angiogram of the inferior epigastric artery branch. He then catheterizes the inferior epigastric (lt), does an angiogram, embolizes it and finally, a LIMA catheterization with angiogram. I have 2 concerns--1. What, if any, diagnostic angiogram code should I use? From his report, it would seem like I could use 75756 and 75716 with possibly 75774 but i am hesitant about the 75716. 2. For the selective catheterizations, would it be 36456 (inferior epigastric branch, 36246-59 (lt internal iliac), and 36215? I know that I need 75894, 37204, and 75898 for the embolization and follow-up. Thanks for any help. Chris