5 Lessons Radiology Coders Should Learn From CCI 15.3
Posted on 15. Oct, 2009 by Editor in Hot Coding Topics
Wonder if there’s a method to the 76001 madness? Here’s where to look for answers.
The silver lining to the 18,000 Correct Coding Initiative (CCI) that just came rumbling in with CCI 15.3. Analyzing them can help you master radiology coding essentials — including follow-up CTs, fluoro, and more. Apply these five lessons to keep your claims looking their best.
Remember: The latest round of edits, version 15.3, went into effect Oct. 1. You can download the updates at the beginning of each quarter from the CMS Web site, suggests Alice E. Wonderchek, CMBS, CPC, billing and coding specialist with Franklin & Seidelmann Subspecialty Radiology in Beachwood, Ohio. You can download the CCI manual here, as well.
1. Proceed With Caution When Coding 76380
Randomly choose a code for computed tomography (CT) or computed tomography angiography (CTA), and odds are that CCI 15.3 bundles 76380 (Computed tomography, limited or localized follow-up study) into it.
Example: The radiologist performs calcium scoring and a follow-up CT. You should report only 0144T (Computed tomography, heart, without contrast material, including image postprocessing and quantitative evaluation of coronary calcium). You should not add 76380 for this claim, according to the new edits.
These additions join edits in place since 1997, bundling 76380 into 71260 (Computed tomography, thorax; with contrast material[s]) and 74150-74170 (Computed tomography, abdomen …). These edits have a modifier indicator of “1,” which means you may override them with a modifier when appropriate.
You may not use 76380 often, but CPT Assistant (July 2007) states that for a limited CT, 76380 is an alternative to using a procedure-specific CT code with modifier 52 appended, says Stacie L. Buck, RHIA, CCS-P, RCC, CIC, president and senior consultant of RadRx in Stuart, Fla.
Example: ACR’s July/August 2006 Radiology Coding Source demonstrates...
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