Last Updated on August 29, 2025 by admin
Interventional radiology coding for abdominal aortography along with lower extremity angiography often poses challenges. The procedures can vary in technique, access points, catheter positioning, and the anatomical areas visualized. Each of these elements influences CPT code selection.
To code these procedures correctly, documentation must be reviewed carefully. What may appear as a single procedure on paper can involve multiple codes based on how it was performed. Coders must be familiar not only with the procedures but also with the relevant anatomy, catheter paths, and imaging scope.
Table of contents
Anatomy of Aorta:
Understanding the aorta’s structure is key to accurate interventional radiology coding. The aorta is the largest artery in the human body, typically measuring around 2 to 3 centimeters in diameter. It is divided into four main sections. Each segment plays a distinct role in circulating blood and is often evaluated separately during imaging or interventional procedures.
- ascending aorta,
- arch of the aorta,
- thoracic aorta, and
- abdominal aorta.
Ascending Aorta: The portion of the aorta that emerges from the left ventricle posterior to the pulmonary trunk is the ascending aorta.
Arch of the Aorta: The ascending aorta arches to the left, forming the arch of the aorta, which descends and ends at the level of the intervertebral disc between the fourth and fifth thoracic vertebrae.
Thoracic Aorta: The section of the aorta between the arch of the aorta and the diaphragm is called the thoracic aorta.
Abdominal Aorta: The section between the diaphragm and the common iliac arteries is the abdominal aorta.
Each division of the aorta gives off arteries that branch into distributing arteries that lead to various organs. Within the organs, the arteries are divided into arterioles and then into capillaries that service the systemic tissues (all tissues except the alveoli of the lungs).
Key CPT Codes for Aortography and Extremity Angiography
There are specific CPT codes for imaging and catheter placement depending on how the procedure was performed. Coders must identify whether the catheter was placed in the aorta directly, repositioned, or remained in place during imaging. Similarly, they must determine which anatomical territories were imaged—abdominal only or including lower extremities.
Radiology Supervision and Interpretation Codes:
CPT 75625 – Abdominal aortography by serialography, with radiological supervision and interpretation.
Appropriate when a complete aortogram is performed with the catheter placed at or above the level of the renal arteries. No separate imaging of the extremities is performed.
CPT 75630 – Abdominal aortography with bilateral iliofemoral runoff by serialography, with radiological supervision and interpretation.
Used when the catheter remains above the renal arteries and bilateral lower extremity arteries (iliofemoral) are imaged in a runoff fashion.
CPT 75710 – Angiography, unilateral extremity, radiological supervision and interpretation
CPT 75716 – Angiography, bilateral extremities, radiological supervision and interpretation
Catheter Placement Codes:
CPT 36200 – Introduction of catheter into the aorta
CPT 36160 – Aortic translumbar catheter placement
Coding Guidelines: CPT 75625 vs CPT 75630
These two CPT codes are commonly misunderstood, especially when it comes to interpreting the extent of imaging and catheter positioning. Knowing when to report 75625 versus 75630 depends largely on the anatomy visualized and whether imaging extended into the lower extremities.
Code 75625 when:
- The catheter is placed at or above the renal arteries
- A complete abdominal aortogram is performed
- There is no imaging of the iliofemoral or extremity vessels
- Imaging of common iliac arteries is only incidental
Code 75630 when:
- The catheter remains above the renal arteries
- Imaging includes bilateral iliofemoral arteries
- A runoff study is performed
- There is no catheter repositioning for leg imaging
If the catheter is moved to a lower position, such as at the aortoiliac bifurcation, to image the lower extremities, CPT 75625 must be reported along with 75716 (bilateral) or 75710 (unilateral), depending on the documentation.
Imaging Considerations and CPT Bundling
In any procedure where a radiological supervision and interpretation (RS&I) code like 75625 or 75630 is used, related abdominal X-rays (e.g., CPT 74018–74022) are bundled and not coded separately.
Coders should also confirm the extent of extremity imaging. To report 75716, the documentation must show imaging of both lower extremities, at least down to the knees or below. If only one limb is imaged, report 75710 instead.
Clinical Examples for Accurate Coding
These scenarios help illustrate how code selection depends on catheter placement and imaging coverage.
Example 1 – Abdominal Aortography Only
- Access: Right femoral artery
- Catheter placed above renal arteries
- Imaging: Only abdominal aorta
- Codes: 36200, 75625
Note – If a translumbar approach was used, report 36160 instead of 36200
Example 2 – Aortography with Bilateral Iliofemoral Runoff
- Access: Right femoral artery
- Catheter placed above renal arteries
- Imaging: Abdominal aorta + bilateral iliofemoral vessels
- No catheter repositioning
- Codes: 36200, 75630
Example 3 – Aortogram Followed by Repositioning for Leg Imaging
- Access: Right femoral artery
- Initial catheter placement above renal arteries
- First, complete abdominal aortogram performed
- Then catheter moved to aortoiliac bifurcation for leg angiography
- Imaging includes bilateral lower extremities
- Codes: 36200, 75625, 75716
Note – If imaging was limited to one leg, replace 75716 with 75710
Interventional radiology comes with a unique set of coding and billing challenges. From detailed procedures like abdominal aortograms and runoff studies to complex catheter placements, accuracy matters, for getting reimbursed on time.
At AnnexMed, we bring that precision to the table. Our certified coders are trained to handle these complexities with care, making sure the right codes are used every time. We understand how one missed detail can lead to delays or denials.
If you’re looking for support that’s both reliable and experienced in IR billing, AnnexMed is ready to step in. We help simplify the process, reduce denials, and keep your cash flow steady.
