AAPC Coding Alert: Simulation Angiogram for Tumor Radioembolization

AAPC recently published an article announcing new procedure coding from CMS to report simulation procedures performed prior to complex embolization with TriNav (TriSalus). Coders and billers should be aware of the appropriate use of HCPCS code C8004, which should be reported by hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) for simulation angiograms performed for treatment planning before tumor radioembolization. This HCPCS procedure code is all-inclusive, covering radiological supervision, intraprocedural roadmapping, imaging guidance, catheter placement, and contrast injections.

Why this matters

Proper reporting of HCPCS code C8004 facilitates reimbursement and ensures compliance, avoids unnecessary denials, and clearly separates treatment planning services from therapeutic procedures such as CPT code 37243. Accurate documentation is critical: providers must document in the patient’s record that the angiogram was performed for simulation purposes, specify the vessels studied, and detail findings that guide therapy planning.

Key reminders for coders:

• C8004 is reported for simulation only (not therapeutic embolization).

• Bundled services—catheterization, imaging guidance, and injections—should not be reported separately.

• Modifier use is appropriate only when a diagnostic angiogram is separately justified by medical necessity.

• Documentation must be explicit: intent, vessels assessed, and findings relevant to treatment.

For the full article and examples, see AAPC’s article: Coding Simulation Angiogram for Tumor Radioembolization.