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Official Description

Angiography, spinal, selective, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 75705 refers to selective spinal angiography, which is a specialized imaging technique used to visualize the blood vessels supplying the spine and spinal cord. This procedure involves the use of a radiopaque contrast medium, which is a substance that enhances the visibility of internal structures during imaging. The primary goal of selective spinal angiography is to assess blood flow to the spine, which can be critical in diagnosing various conditions such as arteriovenous malformations—abnormal connections between arteries and veins that can disrupt normal blood flow—and primary metastatic tumors that may affect the vertebral bodies. The procedure is performed under fluoroscopy, a real-time imaging technique that allows for continuous visualization of the catheter's placement and the flow of contrast medium. The process begins with the insertion of a large bore needle into a blood vessel in the groin, followed by the introduction of a guidewire and catheter into the aorta. The catheter is then navigated to specific paired spinal arteries, including those above and below the diaphragm, where contrast medium is injected to obtain detailed X-ray images. The radiologist oversees the entire procedure, interprets the findings, and provides a comprehensive written report, which is essential for further clinical decision-making.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The indications for performing selective spinal angiography, as described by CPT® Code 75705, include the following:

  • Arteriovenous Malformations - This procedure is indicated for the diagnosis of arteriovenous malformations, which are abnormal connections between arteries and veins that can lead to serious complications if not identified and treated.
  • Primary Metastatic Tumors - Selective spinal angiography is utilized to evaluate primary metastatic tumors affecting the vertebral bodies, aiding in the assessment of tumor vascularity and planning for potential interventions.

2. Procedure

The procedure for selective spinal angiography involves several critical steps, which are detailed as follows:

  • Step 1: Accessing the Blood Vessel - The procedure begins with the insertion of a large bore needle into a blood vessel located in the groin area. This access point is crucial for the subsequent introduction of the guidewire and catheter.
  • Step 2: Introducing the Guidewire - Once the needle is in place, a guidewire is carefully introduced through the needle. This guidewire serves as a pathway for the catheter, ensuring precise navigation through the vascular system.
  • Step 3: Advancing the Catheter - The catheter is then advanced over the guidewire into the aorta, utilizing X-ray guidance to ensure accurate placement. This step is essential for reaching the appropriate arteries that supply blood to the spine.
  • Step 4: Selective Catheterization - The catheter is maneuvered into the specific paired spinal arteries, which may include the intercostal, subclavian, thyrocervical, costocervical arteries above the diaphragm, and the vertebral, internal iliac, lumbar, and median sacral arteries below the diaphragm. This selective approach allows for targeted imaging of the spinal vasculature.
  • Step 5: Injection of Contrast Medium - After the catheter is positioned correctly, a radiopaque contrast medium is injected. This contrast agent enhances the visibility of the blood vessels during imaging, allowing for detailed assessment of blood flow.
  • Step 6: Obtaining X-ray Images - X-ray images are obtained during the injection of the contrast medium, capturing the blood flow to the spine and spinal cord. These images are critical for diagnosing any vascular abnormalities or tumors.
  • Step 7: Catheter Removal - At the conclusion of the procedure, the catheter is carefully removed, and the access site is managed according to standard protocols.

3. Post-Procedure

Post-procedure care following selective spinal angiography typically involves monitoring the patient for any complications related to the vascular access site, such as bleeding or hematoma formation. Patients may be advised to rest and avoid strenuous activities for a specified period. The radiologist will provide a detailed written report of the findings, which will be essential for further clinical evaluation and management. Follow-up appointments may be scheduled to discuss the results and any necessary treatment options based on the angiography findings.

Short Descr ARTERY X-RAYS SPINE
Medium Descr ANGIOGRAPHY SPINAL SELECTIVE RS&I
Long Descr Angiography, spinal, selective, radiological supervision and interpretation
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) 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services 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 99 - Concept Does Not Apply
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) I4B - Imaging/procedure - other
MUE 20
CCS Clinical Classification 191 - Arterio- or venogram (not heart and head)

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.
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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).
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
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
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
GZ Item or service expected to be denied as not reasonable and necessary
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
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
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.
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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