Ask Dr. Z

We have a physican who wants to charge for a central venogram 75827 with a AV fistulogram 36147 because the patients lower extremity graft (superifical femoral artery to femoral vein PTFE loop graft) does not drain into the SVC thus imaging could not be obtained from the leg graft. The SVC, right atrium and the innominate were catheterized and imaged looking for possible placement of new graft. I am uncomfortable with charging for 75827 as CPT guidelines indicate that 36147 includes imaging up to and extending into the right atrium. What is your advice? Thank you.