Tag Archives: radiology
Use 3 CPT, Modifier, and ICD-9 Code Pairs to Ace This X-Ray Claim
Posted on 24. May, 2010 by Editor.
Decipher why you should include a seconding diagnosis.
Question: A 38-year-old patient presents to the emergency room with complaints of wheezing, coughing, and trouble catching her breath. After the nonphysician practitioner (NPP) performs a problem-focused history, the physician performs a detailed history and exam and discovers focal ronchi. The physician orders a two-view chest x-ray to check for upper respiratory infection (URI) The chest x-ray results reveal acute URI, and the ronchi clears up upon reevaluation. The patient is treated with antibiotics. How should I code this scenario?
Answer:
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Radiology Medical Coders – Tighten Up Your LAP-BAND Coding
Posted on 26. Apr, 2010 by Editor.
If your radiologist performs adjustments during the bariatric surgery’s global period, do this.
Question: Our radiologists perform percutaneous LAP-BAND adjustments. We report S2083 for the service and 77002 for the fluoroscopy. Is this the correct fluoroscopy code?
Connecticut Subscriber
Answer:
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Radiology Coding: CPT 2010 Breathes New Life Into Your Respiratory Coding
Posted on 14. Jan, 2010 by Editor.
Master 32561’s guidelines to prevent a major units gaffe.
Flip through the Surgery/Respiratory System section of your CPT 2010 manual, and you’ll see the coding committee has been hard at work adding to and revising your options. Discover the added cath removal code, the all new fibrinolytic agent instillation code, and the reshaped bronchoscopy descriptors, so you can rest assured your coding will be ship-shape in 2010.
1. End Your Hunt for 32550’s Removal Code Match
Until now, CPT has offered insertion code 32550 (Insertion of indwelling tunneled pleural catheter with cuff), but you’ve been left in the lurch for removal, using either an E/M or unlisted code.
CPT 2010 adds new code 32552 (Removal of indwelling tunneled pleural catheter with cuff) to solve this problem, said Stephen Hoffman, MD, associate professor of clinical medicine at Ohio State University Medical Center in Columbus and AMA CPT Advisory Committee American Thoracic Society representative, at AMA’s 2010 annual CPT and RBRVS symposium.
Tube trivia: “Initially, when code 32550 was created, an indwelling tunneled pleural catheter with cuff was inserted for drainage and management of malignant pleural effusions at the end of a patient’s life; therefore, the removal of the catheter was not included in the valuation of 32550,” according to The ACR’s Radiology Coding Source (Sept./Oct. 2009).
Code 32552 now covers the incisions and “subcutaneous dissection of the indwelling cuff” needed to remove the catheter, ACR explains.
Next, watch out for the coding pitfall …
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Radiology Coding Challenge: Total Spine MRI Without Contrast
Posted on 05. Jan, 2010 by Editor.
Question: Which CPT code should I use for a total spine MRI without contrast?
Answer: You won’t find a single CPT code that describes a “total spine” MRI, but you may report a code for each region the radiologist examines:
• 72141 — Magnetic resonance (e.g., proton) imaging, spinal canal and contents, cervical; without contrast material
• 72146 — Magnetic resonance (e.g., proton) imaging, spinal canal and contents, thoracic; without contrast material
• 72148 — Magnetic resonance (e.g., proton) imaging, spinal canal and contents, lumbar; without contrast material.
Support: Reporting all three spine regions (cervical, thoracic, lumbar) is appropriate when the radiologist performs and interprets an MRI of all three regions, according to the July/August 2003 issue of The ACR’s Radiology Coding Source. The ACR recommends that the radiologist dictate separate reports for each separate region studied.
© Radiology Coding Alert. Download your 2 FREE sample issues here.
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HCPCS 2010: Make Room for New MRI Contrast Codes A9581, A9583
Posted on 17. Dec, 2009 by Editor.
AdreView gets its own ‘A’ code, too.
You can leave confusing “not otherwise classified” codes behind for a few more of the contrast agents that you use.
For services on or after Jan. 1, be sure you’re using the product-specific codes detailed below. Not using the proper codes will lead to claim rejection, which means “not receiving the proper reimbursement. And no one wants to start out their new year that way,” points out Lisa Martin, CPC, CPC-IM, CPC-I, an instructor for the AAPC’s Professional Medical Coding Curriculum.
Turn to A958x to See New Options
HCPCS 2010 adds A9583 (Injection, gadofosveset trisodium, 1 ml) to report Vasovist, an intravascular contrast agent designed for MRI.
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How to Code for Screening Mammogram When Radiologist Finds Problem?
Posted on 06. Dec, 2009 by Editor.
Watch out: Results don’t turn screening into diagnostic
Question: A patient presented for a screening mammogram, and the radiologist determined the patient needed an ultrasound for a closer look. The patient returned for that test at a later date. Should I code the original mammogram as 77056 instead of 77057 because the radiologist found a possible problem?
Answer: If the patient presents for and undergoes a screening mammogram, you should code for a screening, even if the radiologist discovers an abnormality. In the case you describe you would report 77057 (Screening mammography, bilateral [2-view film study of each breast]) rather than 77056 (Mammography; bilateral). When the patient returns for the ultrasound, you would report 76645 (Ultrasound, breast[s] [unilateral or bilateral], real time with image documentation). Remember that Medicare requires a separate order for the ultrasound for nonhospital patients.
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Celebrate CT Colonography’s 2010 Move to Category I
Posted on 01. Dec, 2009 by sanjay.aikat.
But don’t assume the new codes will yield improved fees.
Virtual colonoscopy coverage may be a mixed bag, but the AMA showed some confidence in the service by moving its codes from temporary Category III status to full-fledged Category I in 2010.
The switch from Category III to Category I does offer some hope of better reimbursement in the future, says Rhonda Townley, CPC, with University Radiology in Knoxville, Tenn. But don’t make assumptions.
For example, you should continue to check and follow coverage policies for Medicare beneficiaries, she warns. Medicare’s current policy is noncoverage, as announced in its “Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer” (CAG-00396N).
Watch Contrast Use for Diagnostic Test
The details: CPT 2010 deletes 0066T (Computed tomographic [CT] colonography [i.e., virtual colonoscopy]; screening) and 0067T (… diagnostic). But in their place, you’ll have the following 3 codes:
• 74261 — Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material
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Radiology Coding Education: Is 76705 OK for Back?
Posted on 03. Nov, 2009 by Editor.
Question: For a lower back ultrasound of a soft tissue mass, which CPT code is appropriate?
Answer: Code 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) is appropriate for this lower back ultrasound.
Although the code descriptor states “abdominal” and not “back,” CPT Assistant (May 2009) clarifies that 76705 is appropriate for a lower back or abdominal wall soft tissue mass ultrasound.
Bonus tip: You might be surprised to discover these other not-so-obvious anatomy/code pairings that CPT Assistant supports:
• chest wall, upper back: 76604 (Ultrasound chest [includes mediastinum], real time with image documentation)
• pelvic wall, buttock, perineum: 76857 (Ultrasound, pelvic [nonobstetric], real time with image documentation; limited or follow-up [e.g., for follicles])
• upper extremity, axilla, groin, lower extremity: 76880 (Ultrasound, extremity, nonvascular, real time with image documentation).
© Radiology Coding Alert. Download your 2 FREE sample issues here.
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Double Ultrasound Codes Spell Double Trouble With Auditors
Posted on 25. Oct, 2009 by Editor.
Authorities scrutinize medical necessity for 76830 & 76856.
The OIG is watching your ultrasound orders and code combinations — and it doesn’t like what it sees. Take note of these problem spots to keep your claims in the clear.
An OIG audit of ultrasound services billed in 2007 found that nearly one in five ultrasound claims “had characteristics that raise concerns about whether the claims are appropriate,” according to a July 2009 audit report titled “Medicare Part B Billing for Ultrasound.”
The most common error: Roughly 17 percent of 2007 Part B ultrasound claims lacked prior service claims by the ordering physician, the OIG indicated.
What this means: Several physicians ordered ultrasounds for patients that they hadn’t treated within the last year. “The OIG would wonder why the doctor would order an ultrasound for a patient who [the ordering physician] hasn’t examined,” notes Allison Larro, Esq., an Atlanta-based attorney.
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Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s Order
Posted on 22. Oct, 2009 by Editor.
Keep these additional test rules at your fingertips if your want to keep auditors out of your hair.
The Office of Inspector General and Recovery Audit Contractors are out to audit non-compliant ultrasound claims, so knowing the rules is more important than ever. And we’ve got a link and a handy checklist to keep you out of trouble.
If you’re wondering when a radiologist can bill for a test without the treating physician’s order, we’ve got the link where CMS answers your question, plus a handy checklist.
CMS explains when a radiologist can bill for a test without the treating physician’s order in the Medicare Benefit Policy Manual, Chapter 15, Section 80.6.
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