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Q & A with Dr. Z – Lumbar Artery Arteriography


by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC

Question: Lumbar Artery Arteriography
Is arteriography for the lumbar arteries subjective to the reason for the exam? We sometimes see the doctors select L1-L4 and branches off the lumbar arteries to look for bleeds. If the dx is Flank hematoma from a fall and they don’t mention spinal process in the findings, would this be coded 75705 or 75726? (There is evidence of active extravasation from a lateral branch off the right L3/L4 lumbar artery-dx right flank hematoma).

Answer:
Yes. If the arteriography is to look at spinal cord, CPT code 75705 is used. If to look at supply to a liver tumor, or trauma to the ribs (for intercostal arteries), then CPT code 75726 is used. If the imaging is looking at the central portion of lumbar supply to a vertebral body tumor, but also evaluating potential branches to spinal cord, I would use 75705.

Short answer, yes, code to what the intent of the imaging is (just like when you inject the left subclavian from a femoral artery access to look at arm = 36215 and 75710; if to look at vertebral artery = 36225).

 

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About the Author

David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
David Zielske is founder and President of ZHealth Publishing and primary author and editor of ZHealth publications. Dr. Z practiced as an interventional radiologist and has over twenty years experience as a coding reviewer and coding expert. He is Board Certified in Radiology and has functioned as an independent interventional radiology, vascular surgery, and cardiovascular coding consultant to a variety of physician groups and hospital providers across the country. He also served as an instructor for over 200 coding seminars.

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