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How would you code when selective renal angiography is performed on the main renal artery (first-order vessel) in the right kidney, then a selective angiogram is performed on a second-order vessel in the left kidney?
The complete diagnostic renal angiography code choices only give us options for unilateral/bilateral first-order or second-order or higher vessels. Even though imaging is done bilaterally, the imaging isn’t performed at the same level bilaterally, so you would not report this as a bilateral procedure. You would instead need to report the unilateral first order code (36251) and the unilateral second order or higher code (36253) with the appropriate modifier(s) appended.
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