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Official Description

Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A computed tomographic angiography (CTA) of the abdominal aorta and bilateral iliofemoral lower extremity runoff is a specialized imaging procedure that utilizes advanced technology to visualize the blood vessels in these areas. This procedure involves the use of contrast material, which enhances the visibility of the blood vessels during imaging. The process begins with the patient being positioned on a CT table, where an intravenous line is typically inserted into a blood vessel, often in the arm or hand. This line is essential for administering the contrast material, which is injected to provide clearer images of the vascular structures. In some cases, non-contrast images may also be obtained prior to the injection of the contrast to provide baseline data. The CTA employs a combination of computed tomography and angiography techniques, allowing for the acquisition of multiple images that are subsequently processed by a computer. This processing creates detailed, three-dimensional cross-sectional views of the abdominal aorta and the iliofemoral arteries, which are crucial for diagnosing various vascular conditions. The procedure is designed to be efficient, with the CT table moving through the scanning machine as the contrast is injected at a controlled rate. Once the imaging is complete, a radiologist reviews and interprets the resulting images, providing valuable insights into the vascular health of the patient. This comprehensive approach ensures that any abnormalities or issues within the blood vessels can be accurately identified and assessed.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The computed tomographic angiography (CTA) of the abdominal aorta and bilateral iliofemoral lower extremity runoff is indicated for various clinical scenarios where detailed visualization of the vascular structures is necessary. The following conditions may warrant this procedure:

  • Assessment of Vascular Disease This procedure is often performed to evaluate for the presence of vascular diseases such as atherosclerosis, which can lead to narrowing or blockage of the arteries.
  • Investigation of Aneurysms CTA is utilized to detect and assess abdominal aortic aneurysms, which are abnormal bulges in the aorta that can pose significant health risks if they rupture.
  • Evaluation of Peripheral Artery Disease Patients with symptoms of peripheral artery disease, such as leg pain or claudication, may undergo this imaging to assess blood flow in the iliofemoral region.
  • Preoperative Planning Surgeons may request a CTA to obtain detailed images of the vascular anatomy prior to surgical interventions involving the abdominal aorta or lower extremities.
  • Postoperative Assessment Following vascular surgery, CTA can be used to evaluate the success of the procedure and to monitor for any complications such as graft failure or stenosis.

2. Procedure

The procedure for performing a computed tomographic angiography (CTA) of the abdominal aorta and bilateral iliofemoral lower extremity runoff involves several key steps to ensure accurate imaging and patient safety. The following outlines the procedural steps:

  • Patient Preparation The patient is first prepared for the procedure by explaining the process and obtaining informed consent. The patient is positioned comfortably on the CT table, and any necessary pre-procedure assessments are conducted.
  • Intravenous Access An intravenous (IV) line is established, typically in the patient's arm or hand. This IV line is crucial for administering the contrast material that enhances the visibility of the blood vessels during imaging.
  • Non-Contrast Imaging If indicated, non-contrast images may be obtained prior to the administration of contrast material. These images serve as a baseline for comparison and help in the interpretation of the subsequent contrast-enhanced images.
  • Contrast Administration A small dose of contrast material is injected through the IV line. Test images may be taken to verify the correct positioning of the contrast. Once confirmed, the full contrast injection is performed at a controlled rate.
  • CT Scanning As the contrast material circulates through the blood vessels, the CT table moves through the CT machine. The scanner captures multiple images of the abdominal aorta and bilateral iliofemoral arteries, creating detailed cross-sectional views.
  • Image Postprocessing After the scanning is completed, the acquired images undergo postprocessing on a computer. This step involves reconstructing the images into three-dimensional views that provide comprehensive insights into the vascular structures.
  • Image Review Finally, a radiologist reviews and interprets the CTA images, assessing for any abnormalities or conditions that may require further clinical attention.

3. Post-Procedure

After the completion of the computed tomographic angiography (CTA), the patient is monitored for any immediate reactions to the contrast material. It is important to ensure that the patient is stable and does not exhibit any adverse effects. The radiologist will analyze the images and prepare a report detailing the findings, which will be communicated to the referring physician. Depending on the results, further diagnostic testing or treatment may be recommended. Patients are typically advised to drink plenty of fluids post-procedure to help flush the contrast material from their system. Any specific post-procedure instructions or follow-up appointments will be provided based on the individual patient's needs and the findings from the CTA.

Short Descr CT ANGIO ABDOMINAL ARTERIES
Medium Descr CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
Long Descr Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 88 -
APC Status Indicator T-Packaged Codes
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I2B - Advanced imaging - CAT/CT/CTA: other
MUE 1
CCS Clinical Classification 189 - Contrast aortogram

This is a primary code that can be used with these additional add-on codes.

37252 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
37253 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
GC This service has been performed in part by a resident under the direction of a teaching physician
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MH Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
MF The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
32 Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
ET Emergency services
GQ Via asynchronous telecommunications system
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
JZ Zero drug amount discarded/not administered to any patient
LT Left side (used to identify procedures performed on the left side of the body)
MB Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
RT Right side (used to identify procedures performed on the right side of the body)
U2 Medicaid level of care 2, as defined by each state
U6 Medicaid level of care 6, as defined by each state
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2008-01-01 Changed Code description changed.
2001-01-01 Added First appearance in code book in 2001.
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