Summary & Overview
CPT 75827: Superior Vena Cava Venography with Serialography
CPT code 75827 covers the supervision and interpretation of superior vena cava venography with serialography, an invasive fluoroscopic procedure performed after contrast injection to detect and characterize central venous thrombus or obstruction. This code is clinically important for diagnosing central venous occlusion, staging thrombotic disease, and guiding subsequent interventional management. Nationally, use of this code reflects demand for advanced vascular imaging in acute and subacute presentations of suspected central venous thrombosis.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of typical clinical indications, the usual sites of service, and how the code maps to diagnostic workflows. The publication also provides benchmarking context where available, notes common billing modifiers, and summarizes payer coverage themes and policy considerations relevant to hospital and outpatient imaging providers.
The content is aimed at hospital administrators, radiology groups, and coding professionals seeking a clear operational and clinical picture of CPT code 75827. It highlights what users should expect when documenting the procedure, the clinical scenarios in which it is most relevant, and the aspects of billing and reimbursement that commonly affect claims for invasive venography services.
Billing Code Overview
CPT code 75827 describes the supervision and interpretation of superior vena cava venography with serialography. This is an invasive diagnostic vascular imaging procedure in which contrast dye is injected and rapid-sequence X‑ray images are captured to evaluate the superior vena cava and adjacent central veins. The procedure identifies the location and degree of intraluminal thrombus or obstruction.
Service type: Diagnostic invasive vascular imaging with contrast and serial radiographic imaging
Typical site of service: Hospital radiology suite, interventional radiology department, or advanced outpatient imaging center where invasive venography is performed under fluoroscopic guidance
Clinical & Coding Specifications
Clinical Context
A 64-year-old male with a history of lung cancer and a recent onset of facial and upper extremity swelling presents with progressive dyspnea and venous congestion. Clinical suspicion is for superior vena cava (SVC) syndrome due to intrathoracic mass effect or thrombosis. The patient is scheduled for superior vena cava venography with serialography under fluoroscopic guidance to evaluate the location, extent, and degree of luminal obstruction or thrombus.
The clinical workflow: the patient is consented and assessed for contrast allergy and renal function. Vascular access is obtained (commonly via peripheral upper extremity or right internal jugular venous access). Under fluoroscopy the interventional radiologist or vascular specialist injects iodinated contrast and acquires rapid sequence images (serialography) of the venae cavae to document stenosis, occlusion, or thrombus. Supervision and interpretation are performed by the credentialed interpreting provider, with images archived to the PACS and a formal report issued detailing findings and recommendations for possible subsequent intervention (angioplasty, stent placement, catheter-directed thrombolysis) if indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation is billed and the technical component is billed separately. |