Billing and Coding: Aortography and Peripheral Angiography

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L36767, Aortography and Peripheral Angiography. Please refer to the LCD for reasonable and necessary requirements. Coding Guidance Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier. CMS issued HCPCS code G0278 for femoral or iliac angiography when done at the time of coronary angiography. Medicare would not expect to see a high percentage of femoral or iliac angiography done at the same time of coronary studies, and such billing could be subject to review. Documentation Requirements All documentation must be maintained in the patient’s medical record and made available to the contractor upon request. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed. The operating physician should retain in the patient’s medical records the history and physical examination and notes documenting the evaluation and management of one of the Medicare covered conditions/diagnoses, including relevant clinical signs/symptoms or abnormal diagnostic test results. The treating physician order for the renal angiography performed at the time of cardiac catheterization must specifically request this extra angiographic service with documentation supporting medical necessity and made available upon request.