How is interventional radiology coded differently from diagnostic radiology?

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Interventional radiology (IR) and diagnostic radiology are coded differently due to the nature and complexity of the procedures involved.

1. Purpose and Scope

• Diagnostic radiology involves imaging only (e.g., X-rays, CT, MRI) to detect or monitor disease.

  • CPT codes reflect the type of imaging and body part (e.g., 71045 for chest X-ray).

  • Often includes a global code: technical + professional components.

• Interventional radiology includes imaging + a procedure (e.g., biopsies, catheter placements, embolizations).

  • Codes must capture:

    • Procedure performed

    • Imaging guidance used

    • Vascular access or catheter work

    • Supervision and interpretation (S&I)

2. Coding Components in IR

IR coding often uses multiple CPT codes to reflect:

• Access (e.g., vascular puncture)

• Procedure (e.g., stent placement, embolization)

• Imaging guidance (e.g., fluoroscopy, ultrasound)

• S&I codes (e.g., 75978 for angioplasty interpretation)

Example:

• Uterine artery embolization may include:

  • Catheter placement (36247)

  • Embolization procedure (37243)

  • Imaging guidance (75894)

3. Bundling and Documentation

• IR often involves bundled codes, where imaging guidance is included in the procedural CPT.

• Detailed physician documentation is essential to capture all components.

Key Difference:

• Diagnostic radiology = imaging only.

• Interventional radiology = procedure + imaging guidance, coded separately or as bundles depending on CPT rules.

Correct coding ensures proper reimbursement and compliance.

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