Radiology Coding Tips: Mammograms, CTs, MRIs and More

Radiology coding is multi-faceted. Here are some foolproof radiology coding tips that will make radiology coding clear cut. Learn about recent CCI edits, mammogram coding, CT coding and more.

Find CCI Edits Before Charging Fluoroscopy

Recent CCI edits reveal a list of all the operating room procedures that are incidental with fluoroscopy codes 76000 and 76001. Guidelines for using fluoroscopy codes 76000 and 760001 can be found online at: http://www.cms.hhs.gov/NationalCorrectCodInitEd/. You’ll find both hospital and physician edits available for download.

You’ll also find plenty of edits for 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) and 76001 (Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician [e.g., nephrosto-lithotomy, ERCP, bronchoscopy, transbronchial biopsy]).

Important: When CCI lists fluoro as a Column 2 code, you should not append a modifier to override the edit unless the fluoro is for a separate encounter or on a separate body part. If CPT or CCI doesn’t define fluoro as part of a procedure, you can report fluoro for a physician who supervises and interprets the flurosocopy during an operative procedure.

The physician must document fluoro use and what it revealed. Be sure to use modifier 26 for physician coding for hospital procedures.

Time: CPT defines 76000 and 76001 in terms of physician time. The physician does not have to personally operate the fluoro machine, but he is required to supervise the technologist who is operating it and must interpret the images. The op report again should indicate fluoro use and findings.

If you’re billing for the hospital, and the operating room (OR) isn’t...