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Complex Carotid and Selections

Date: Jun 13, 2014

Question:

I need help with the coding of the catheterizations and angiograms for the following procedure: "The patient has an AVM in the apex of the right lung. There was not a previous diagnostic angiogram. He punctured the right brachial artery, then he advanced to the right subclavian where he catheterized and did diagnostic angiograms of the following: 1) AVM feeding vessel that arises from the right subclavian. 2) Right thyrocervical trunk with selective catheterization of the dorsal scapular, the inferior thyroidal, and the suprascapular arteries respectively. The dorsal scapular came off the transverse cervical. 3) Right vertebral artery to verify that it was not feeding the AVM. He then embolized the AVM feeding vessel." With these new bundled codes in the head/neck, I am not sure how to code this procedure. Can I only report vertebral catheterization code 36226 and add 75774 for all of the other angios? Or can I code for the selective caths using the old 36215-36218?

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