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Pulmonary angiography, as described by CPT® Code 75746, is a specialized vascular imaging procedure aimed at assessing blood flow within the lungs. This technique is crucial for visualizing the condition of the pulmonary vessels, allowing healthcare professionals to identify potential issues such as vessel wall integrity, narrowing (stenosis), or blockages (embolism). The procedure is particularly valuable in diagnosing and managing various pulmonary conditions, including embolisms, arteriovenous malformations, pseudoaneurysms, and cavitary or inflammatory lung lesions. Additionally, it can be utilized to retrieve foreign objects, such as fragments from catheters or inferior vena cava filters, that may pose a risk to the patient’s health. During the procedure, a large bore needle is typically inserted into a blood vessel located in the groin or neck. A guidewire is then introduced through this needle, followed by the advancement of a catheter over the guidewire. This catheter is carefully navigated through the right side of the heart and into the main pulmonary artery, all under the guidance of imaging technology. In the case of a nonselective study, as indicated by CPT® Code 75746, a contrast dye is injected into the main pulmonary artery, allowing for real-time observation of blood flow. The resulting images can be recorded for further analysis or comparison with previous studies. In contrast, a selective study involves advancing the catheter into the right and/or left arteries that branch off from the main pulmonary artery, enabling a more detailed examination of the smaller lobar or segmental branches of the pulmonary vasculature. This comprehensive approach ensures that the radiologist can provide a thorough review and interpretation of the findings, contributing to informed clinical decision-making and patient management.
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The indications for performing pulmonary angiography, specifically under CPT® Code 75746, include the following conditions and symptoms:
The procedural steps for pulmonary angiography under CPT® Code 75746 are as follows:
After the pulmonary angiography procedure, patients are typically monitored for any immediate complications, such as bleeding or adverse reactions to the contrast dye. Recovery may involve a short observation period, during which vital signs are checked, and the insertion site is assessed for any signs of hematoma or infection. Patients are usually advised to rest and may be instructed to avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to discuss the results of the angiography and any further management plans based on the findings.
| Short Descr | ARTERY X-RAYS LUNG | Medium Descr | ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I | Long Descr | Angiography, pulmonary, by nonselective catheter or venous injection, 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 1 | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Guideline information changed. |
| 2011-01-01 | Changed | Short description changed. Guideline information changed. |
| Pre-1990 | Added | Code added. |
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