Interventional Radiology Coding

When the catheter is placed in the Common Iliac with S&I performed, advanced to the Common Femoral with S&I performed, and then advanced to the Superficial Femoral Artery with S&I performed, is it appropriate to code the procedure as:
36247, 75710-26, 75774-26, 75774-26-59

I have received a denial and would appreciate your expertise.
Thank you!

75774

To code accurately would have to see the documentation to say 100% because medical necessity drives the coding in this case. SIR has stated that additional runs of the same vessels (which is what this would be) are not separately coded. You can only assign 75774 if they are doing a selective study of vessels that they could not previously image or adequately evaluate. For example, if they did a shot from the aorta or common iliac down the leg and there was severe peripheral vascular disease and they could not adequately visualize the SFA. If they advanced the catheter down the leg to obtain selective angiography to better visualize and evaluate the vessel(s) then that would be separately coded. Just indicating that they advanced the catheter and took selective images would not support 75774(s). Documentation is critical in these types of cases.

Contralateral??

in the hierachy of coding for catheter placement , we really need to know the laterality of site of insertion.