What diagnoses would be accepted for medical necessity of renal angiography performed during cardiac catheterization?
There is no predefined set of covered diagnoses for selective or nonselective renal angiography when performed during cardiac catheterization. As for all services reimbursed by Medicare, medical reasonableness and necessity by Medicare’s criteria must be present and documented in the medical record. The close proximity of the catheter to the renal arteries and the relative ease with which renal arteriograms could be accomplished is not sufficient, even if the patient suffers from a condition that under certain circumstances may require evaluation with renal arteriography. As an example, the mere presence of hypertension does not justify this study, unless the provider has reason to believe and documents in the medical record that the hypertension is renovascular (accelerated course, resistance to treatment, renal artery bruits, and other features of renovascular hypertension). Furthermore, renal angiography is typically not a first-line diagnostic modality. Providers should code the di
