Ask Dr. Z

We are performing SIR sphere embolization for hepatic cancer at our facility, and it is done in two encounters. The first time the patient is seen, extensive angiography is done of the celiac, common hepatic, right hepatic, etc. Sometimes the gastroduodenal artery is embolized with coils. MAA is administered. A few weeks later, the patient comes back for the SIR sphere embolization, and the physician does some angiography of the same vessels as in the previous encounter. Since the patient has already had diagnostic angiography during the first encounter, can we bill for angiography again for the second encounter since the embolization of the GDA may have altered the blood flow to the lesion?