There are multiple ways this procedure can be performed, and how it is performed impacts the way the procedure will be coded. Generally, the catheter is placed at or above the level of the renal arteries and contrast is injected. Because the aorta carries blood away from the heart, the flow will carry the contrast down to the lower part of the abdominal aorta and into the iliofemoral arteries.
This imaging can be done from the initial high catheter placement in the aorta, without repositioning the catheter to the lower part of the abdominal aorta. CPT® code 75630 describes abdominal aortography with bilateral iliofemoral runoff from this single high catheter position.
More commonly, the catheter will be repositioned to the lower part of the abdominal aorta for the imaging of the iliofemoral arteries. When the catheter is moved to a lower position for imaging of the lower extremities, two codes would be assigned: 75625 and 75716 (bilateral lower extremities – 75710 for unilateral).
Even though the radiologist is viewing and commenting on the same structures for both coding options, the difference when choosing the correct code is how the procedure was performed. The movement, or lack of movement, of the catheter is the key.