AMA Clinical Examples in Radiology - 2011 Issue 4 (Fall)
Renal Arteriogram
Renal Arteriogram Clinical History A 49-year-old male, status–post motor vehicle accident, with a left renal laceration and possible extravasation suggested on abdomen and pelvis computed tomography (CT) scan. Procedure Left renal arteriogram. Medications Versed, 3 mg intravenously (IV); fentanyl, 150 mcg IV; moderate conscious sedation was monitored for 45 minutes by the radiology nursing staff. Contrast 40 ml intra-arterial. Complications None. Technique 36251 Access to the right common femoral artery was achieved via a double wall puncture. Flush aortography and first-order left renal arteriography were performed with selective catheterization of both left renal arteries. The catheter was then removed...
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Article Overview
This article explains the coding context for a renal arteriogram case and discusses how the procedure is documented and reported in radiology coding references. It covers CPT renal angiography code structure, bundled service components, and a related quality reporting code mentioned in the report. The piece is aimed at coders, billers, radiology staff, and others responsible for accurate procedural reporting and documentation review.
Why This Topic Matters
Renal angiography coding changed with newer bundled CPT options, so understanding the article helps readers recognize which procedure elements are represented in the report and how quality reporting documentation is referenced in the radiology setting.
Article Sections
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Clinical History
Summarizes the patient context and the reason the study was performed.
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Procedure
Identifies the imaging procedure documented in the case.
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Medications
Lists medications administered during the encounter and notes the monitored sedation component.
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Contrast
States the contrast administration details recorded for the study.
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Complications
Notes whether any immediate complications were documented.
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Technique
Describes the catheter access and angiographic technique used during the examination.
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Findings
Summarizes the angiographic findings and anatomic observations.
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Impression
Provides the interpretive summary of the study results.
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How to Code
Discusses the coding approach for the documented radiology service and related reporting considerations.
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Coding Tips
Offers general coding notes about renal angiography reporting, bundled services, and associated documentation topics.
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Discussion
Reviews the broader coding background, including renal angiography code updates and related procedural context.
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References
Lists source references and professional publications cited by the article.
What You Will Learn
- How the renal arteriogram case is structured in a radiology report
- Which broad CPT renal angiography coding topics are discussed
- How bundled service concepts are addressed in the article
- What related quality reporting documentation is mentioned
- How the article frames renal angiography within broader radiology coding references
Who Should Read This
- Radiology coders
- Medical billers
- Interventional radiology staff
- Coding educators
- Physician documentation reviewers
Codes Discussed
Code Ranges Discussed
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