Ask Dr. Z

Please explain when to code for catheter placement when diagnostic angiography is done followed by an intervention, such as angioplasty/stent in the lower extremities. The procedure today contained the following: "Catheter inserted in left common femoral (contrast injected here), then placed in the distal aorta with angiography and repositioned in right superficial femoral artery with angiography, and then repositioned in the right poplitieal artery with angiography. Then a catheter was inserted in the left common femoral artery with angioplasty of the left posterior tibial artery (same leg)." Should code 36247 have been reported?

Also, is the following still true for 2014 (CPT Assistant July 2011): Code catheter placement codes when diagnostic angiography performed at the same time as the intervention(s) requires a higher degree of selectivity than does the intervention." If so, can you provide an example? What should I look for regarding coding catheter placement with lower extremity angiography/intervention (for example, code when diagnostic angiogram is through a separate access)?