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Official Description

Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Angiography, visceral, selective or supraselective, with or without flush aortogram, is a specialized vascular imaging procedure designed to assess blood flow within the arteries that supply the bowel, liver, and spleen. This procedure is particularly valuable in diagnosing various vascular conditions, including bleeding, blockages, and other abnormalities that may affect these critical organs. During the procedure, a large-bore needle is typically inserted into a blood vessel located in the groin area, allowing for the introduction of a guidewire. This guidewire facilitates the advancement of a catheter into the abdominal aorta under X-ray guidance. An initial flush aortogram may be performed to evaluate blood flow and the integrity of the vessel walls within the abdominal aorta and its proximal arteries. Subsequently, a smaller catheter is maneuvered into specific branches of the abdominal aorta, such as the celiac axis, superior mesenteric artery, and inferior mesenteric artery. Contrast dye is then injected into the selected vessels, enabling real-time visualization of blood flow. The entire imaging process may be recorded for further analysis or comparison with previous studies. The CPT® Code 75726 encompasses the radiologist's role in supervising the angiography procedure, interpreting the results, generating a written report, and consulting with referring physicians regarding the diagnosis and potential need for additional tests or interventions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Visceral angiography, selective or supraselective, with or without flush aortogram, is indicated for various clinical scenarios where detailed visualization of the vascular structures supplying the bowel, liver, and spleen is necessary. The following conditions may warrant this procedure:

  • Diagnosis of Vascular Abnormalities - This procedure is utilized to identify and evaluate abnormalities such as aneurysms, stenosis, or occlusions in the visceral arteries.
  • Assessment of Gastrointestinal Bleeding - It is often performed to locate the source of unexplained gastrointestinal bleeding, allowing for targeted interventions if necessary.
  • Evaluation of Tumors - Visceral angiography can assist in assessing the vascular supply of tumors in the liver or other abdominal organs, aiding in treatment planning.
  • Trauma Assessment - In cases of abdominal trauma, this procedure helps in evaluating potential vascular injuries that may require surgical intervention.

2. Procedure

The visceral angiography procedure involves several critical steps to ensure accurate imaging and assessment of the vascular structures. The following outlines the procedural steps:

  • Step 1: Accessing the Blood Vessel - The procedure begins with the insertion of a large-bore needle into a blood vessel, typically located in the groin area. This access point is crucial for the subsequent introduction of a guidewire.
  • Step 2: Guidewire Introduction - A guidewire is carefully introduced through the needle into the blood vessel. This guidewire serves as a pathway for the catheter that will be advanced into the vascular system.
  • Step 3: Catheter Advancement - A catheter is then advanced over the guidewire into the abdominal aorta, utilizing X-ray guidance to ensure proper placement. This step is essential for accessing the major arteries branching from the aorta.
  • Step 4: Initial Flush Aortogram - At this stage, an initial flush aortogram may be performed. This involves injecting contrast dye to visualize blood flow and assess the integrity of the vessel walls within the abdominal aorta and its proximal arteries.
  • Step 5: Selective Catheterization - Following the aortogram, a smaller catheter is threaded into the selected visceral arteries, such as the celiac axis, superior mesenteric artery, and inferior mesenteric artery. This allows for targeted imaging of specific vascular territories.
  • Step 6: Contrast Injection and Imaging - Contrast dye is injected into the selected vessel(s), enabling real-time visualization of blood flow. The imaging is monitored closely to assess any abnormalities or areas of concern.
  • Step 7: Documentation and Reporting - The imaging procedure may be recorded for further analysis or comparison with previous examinations. The radiologist will then provide a comprehensive report detailing the findings and any recommendations for further evaluation or intervention.

3. Post-Procedure

After the completion of the visceral angiography, patients are typically monitored for any immediate complications, such as bleeding or vascular injury at the access site. Recovery may vary depending on the individual and the complexity of the procedure, but patients are generally advised to rest and avoid strenuous activities for a short period. Follow-up care may include reviewing the imaging results with the referring physician to discuss the findings and any necessary next steps, which could involve further diagnostic testing or therapeutic interventions based on the results of the angiography.

Short Descr ARTERY X-RAYS ABDOMEN
Medium Descr ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I
Long Descr Angiography, visceral, selective or supraselective (with or without flush aortogram), 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 3
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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GC This service has been performed in part by a resident under the direction of a teaching physician
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.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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
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
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
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
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
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
RT Right side (used to identify procedures performed on the right side of the body)
SU Procedure performed in physician's office (to denote use of facility and equipment)
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
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
2011-01-01 Changed Short description changed.
2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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