Ask Dr. Z

There is some disagreement on billing the following situation: "Patient presents with subarachnoid hemorrhage. Diagnostic cervicocerebral was performed with catheter placement in both right and left common carotid arteries. Angiography was performed, showing critical narrowing of the left middle cerebral artery due to vasospasm. There was also narrowing of the right middle cerebral artery. Catheter was removed. Then a microcatheter was positioned in the left internal carotid artery, which was confirmed by angiography. The catheter was infused with 10 mg of verapamil for 40 minutes. Follow-up angiography was performed after the 40 minutes of infusion." I would bill codes 37202-59, 36223-50, 75896-26-59, and 75898-26. Others feel code 36216 should also be billed for the microcatheter in position in the left internal carotid artery. What are your thoughts?