75605
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
1.11
Facility
$168.87
Non-Facility
$168.87
Documentation Required
- Maintain complete, legible medical records for the patient with patient identification (e.g., full name, dates of service) available to the contractor upon request.
- The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing care.
- The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
- The operating physician must retain history and physical and notes documenting evaluation and management of a Medicare-covered condition/diagnosis, including relevant clinical signs/symptoms or abnormal diagnostic test results.
Key Coverage Criteria
- Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
- Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.
- An IDTF must be credentialed and approved by Palmetto GBA provider enrollment to bill Medicare for a specific diagnostic procedure or material.
- Additional services and supplies (e.g., radiopharmaceuticals, special contrast agents, medications) are payable to an IDTF when the diagnostic test itself is payable and the supplies are commonly separately reimbursed to a physician in an office setting.
- A supervising physician for an IDTF must be licensed in the state(s) where tests are performed, enrolled in Medicare, not excluded, meet proficiency standards for tests supervised, and provide general supervision for no more than three IDTF sites.
- An interpreting physician must be licensed in the state(s) where tests are performed, enrolled in Medicare, not excluded, and qualified to interpret the types of tests (codes) listed on the IDTF enrollment application.
10 Active Policies
L36767 — Aortography and peripheral angiography
J09
A57056 — Billing and Coding: Aortography and Peripheral Angiography
J09
L33693 — Peripheral Venous Ultrasound
J09
L35434 — Oximetry Services
J12
L35451 — Peripheral Venous Ultrasound
Related Codes
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