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Official Description

Angiography, pelvic, selective or supraselective, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Selective or supraselective pelvic angiography is a specialized imaging procedure that allows for the detailed visualization of blood vessels located in the pelvic region. This technique is primarily utilized to diagnose various medical conditions, assess traumatic injuries, or create a vascular map prior to elective surgical interventions or embolization procedures. The pelvic blood vessels originate from the aorta and include several key arteries such as the inferior vesical artery in males, which supplies blood to the base of the bladder and subsequently forms the prostatic artery. Other important vessels include the medial rectal artery, the internal pudendal artery—which supplies blood to the anal muscles and perineum and branches into the dorsal artery of the penis or clitoris, as well as the inferior rectal artery—the inferior gluteal artery, and the uterine artery, which provides blood to the broad ligament, ureter, uterus, uterine tube, ovaries, and vagina, with a branch extending to the vaginal artery. Additionally, the superior rectal artery, median sacral artery, and ovarian artery also traverse into the pelvic area. The angiography procedure employs X-ray guidance along with contrast dye to enhance the visibility of these blood vessels. Access to the vascular system is typically achieved through the femoral artery, where a catheter is carefully advanced up to the aorta and into the targeted pelvic vessels. Once the catheter is positioned, contrast dye is injected into the selected or supraselected vessel(s), allowing for real-time observation of blood flow. The imaging process captures dynamic video and/or still images, providing critical information for diagnosis and treatment planning. At the conclusion of the procedure, the catheter is removed, and the code 75736 encompasses the radiologist's oversight of the angiography, including the interpretation of the results, the generation of a written report, and any necessary consultations with referring physicians regarding the findings and potential follow-up actions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Selective or supraselective pelvic angiography is performed for various clinical indications, including:

  • Diagnosis of Disease This procedure is utilized to identify vascular diseases affecting the pelvic region, which may include conditions such as aneurysms, stenosis, or vascular malformations.
  • Assessment of Traumatic Injury It is indicated for evaluating injuries to the pelvic blood vessels that may occur due to trauma, helping to determine the extent of damage and necessary interventions.
  • Preoperative Mapping The angiography is often conducted to map the pelvic vasculature prior to elective surgical procedures, ensuring that surgeons have a clear understanding of the blood supply to the area.
  • Embolization Procedures This imaging technique is also indicated for planning embolization procedures, where specific blood vessels are intentionally occluded to treat conditions such as fibroids or tumors.

2. Procedure

The procedure for selective or supraselective pelvic angiography involves several critical steps:

  • Vascular Access The procedure begins with the establishment of vascular access, typically through the femoral artery. This access point allows the physician to introduce a catheter into the vascular system.
  • Catheter Advancement Once access is secured, a catheter is carefully threaded through the femoral artery and advanced up to the aorta. The physician navigates the catheter to the specific pelvic vessels that branch off from the aorta, targeting the areas of interest for imaging.
  • Contrast Injection After positioning the catheter in the desired vessel, contrast dye is injected. This dye enhances the visibility of the blood vessels during imaging, allowing for a clearer assessment of blood flow and vascular structures.
  • Real-Time Imaging The angiography is conducted under X-ray guidance, capturing real-time images of the blood flow within the pelvic vessels. This may include both dynamic video and still images, providing comprehensive visual data for analysis.
  • Procedure Conclusion At the end of the imaging process, the catheter is carefully removed from the vascular access site. The radiologist then reviews the captured images and prepares a report detailing the findings.

3. Post-Procedure

After the completion of the selective or supraselective pelvic angiography, patients may be monitored for a short period to ensure there are no immediate complications from the procedure. It is important to assess the access site for any signs of bleeding or hematoma formation. Patients are typically advised to rest and may be instructed to avoid strenuous activities for a specified duration. The radiologist will provide a written report of the findings, which may include recommendations for further tests or procedures if necessary. Follow-up consultations with the referring physician may also be arranged to discuss the results and any subsequent treatment plans.

Short Descr ARTERY X-RAYS PELVIS
Medium Descr ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I
Long Descr Angiography, pelvic, selective or supraselective, 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 2
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
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
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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).
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
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
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
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right 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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
Date
Action
Notes
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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