1. Procedure Details and CPT® Code Selection:
The patient underwent a catheter placement in the proper hepatic artery (a visceral artery), followed by dye injection and imaging to identify a stenosis, and finally a percutaneous transluminal angioplasty of the artery.
Code 36247 is appropriate for selective catheter placement in the third-order or more selective branch of a visceral artery. Since the proper hepatic artery is a selective branch accessed from the left femoral artery, this code accurately describes the catheter placement.
Code 75736 is for angiography of a selective visceral artery following catheter placement, which matches the imaging procedure performed here.
Code 37248 describes a percutaneous transluminal angioplasty of a visceral artery, which is the therapeutic intervention performed to treat the stenosis in the proper hepatic artery.
2. Modifiers:
Modifier 26 is used with 75736 to denote the professional component of the imaging service.
Modifier 59 indicates that the imaging (75736) is a distinct procedural service, separate from the therapeutic angioplasty (37248).
Modifier 51 is applied to 37248 to indicate it was a secondary procedure in addition to the diagnostic imaging and catheter placement.
3. Exclusion of Other Options:
Code 36253 (in choices A and D) is for selective catheter placement in a different vessel and does not apply to the hepatic artery.
Code 75726 is for non-selective abdominal aortography, which does not match the specific selective imaging of the hepatic artery.
4. AAPC and CPT® Coding Guidelines:
According to AAPC guidelines, each step in an angiographic and interventional radiology procedure is coded based on the level of vessel accessed, imaging performed, and therapeutic intervention completed, which is all accurately represented by 36247, 75736-26-59, and 37248-51.
Based on CPT® and AAPC coding guidelines, the correct answer is C. 36247, 75736-26-59, 37248-51.
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