Ask Dr. Z

We are in disagreement with the pulmonary angiogram codes and the number of coil closures that can be billed for this case. The procedures were right and retro left heart cath for CHD, selective right and left pulmonary angiograms, and multiple subsegmental pulmonary angiograms. The embolizations performed were: 1) Inferior lateral basilar right lower pulmonary artery, 2) posterior segmental lateral basilar right lower pulmonary artery, 3) posterior-superior subsegmental accessory right upper pulmonary artery, 4) antero-inferior subsegmental accessory right upper pulmonary artery, 5) apical segmental right upper pulmonary artery, 6) medial and lateral subsegmental anterior right upper pulmonary arteries.

Code suggestions have been:

1. 93531, 93568, 37242 x 2 (right upper and right lower as two separate surgical fields)
2. 93531, 93568 multiple times for the pulmonary and subsegmental angiograms, and 37242 x 6
3. 93531, 93463, 93568, 36015/75741 multiple times for the subsegmental pulmonary angiograms, and 37242 x 6