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Internal mammary angiography is a specialized vascular procedure that focuses on assessing the blood flow through the internal mammary artery, which is also known as the internal thoracic artery. This artery originates from the subclavian artery and plays a significant role in cardiovascular procedures, particularly as a potential graft during coronary artery bypass surgery. The primary purpose of this angiography is to visualize the internal mammary artery's structure and function, allowing healthcare professionals to identify any abnormalities such as narrowing (stenosis) or blockages (embolism) that could impede blood flow. The procedure involves the use of imaging technology to guide the placement of a catheter into the artery, enabling the injection of contrast dye. This dye enhances the visibility of the blood vessels on imaging studies, allowing for real-time observation of blood flow. Additionally, the findings from the angiography can be documented and analyzed further, providing critical information for the diagnosis and management of cardiovascular conditions. The CPT® Code 75756 specifically denotes the radiological supervision and interpretation of this angiographic procedure, which includes the radiologist's oversight, the analysis of the imaging results, the generation of a written report, and any necessary consultations with referring physicians regarding the implications of the findings and potential next steps in patient care.
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Internal mammary angiography is performed for several specific indications related to the evaluation of the internal mammary artery and its associated vascular structures. The following conditions may warrant this procedure:
The internal mammary angiography procedure involves several critical steps to ensure accurate visualization and assessment of the internal mammary artery. The following procedural steps are typically followed:
After the completion of the internal mammary angiography, the patient is typically monitored for any immediate complications or adverse reactions to the contrast dye. It is essential to assess the access site for bleeding or hematoma formation. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. The radiologist will prepare a written report detailing the findings from the angiography, which will be shared with the referring physician. This report may include recommendations for further tests or procedures based on the results of the angiography, ensuring that the patient receives appropriate follow-up care.
| Short Descr | ARTERY X-RAYS CHEST | Medium Descr | ANGIOGRAPHY INTERNAL MAMMARY RS&I | Long Descr | Angiography, internal mammary, 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) | I4A - Imaging/procedure - heart including cardiac catheter | MUE | 2 | CCS Clinical Classification | 47 - Diagnostic cardiac catheterization, coronary arteriography |
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. | 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. | 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). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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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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