Abdominal/Pelvic CTA: 74174: Ace CT vs. CTA and CCI Edits for Cleaner Claims (February 2012)
A little runoff CTA know-how can help prevent a lot of denials. You have a new code to consider for abdominal/pelvic CTA claims in 2012. Get up to speed on proper use, guidelines, and coding edits with this quick primer. Ease Into 74174 With 74176-74178 Comparison CPT® 2012 introduced a new code that’s appropriate when you need to report abdominal and pelvic CTA performed concurrently: 74174 (Computed tomographic angiography, abdomen and pelvis, with contrast material[s], [...]
Similar revisions are now in place for 36200.If you want proof that annual code updates go beyond definition revisions, check out these moderate sedation and global surgical package changes to 36200 and 36245-+36248.1. Revision Sign Indicates Moderate Sedation ChangeYou’ll find the following codes on the list of revised codes for 2012:36200, Introduction of catheter, aorta36245, Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family 36246, [...]
ICD-10-CM: 571.5 Crosses to a Trio of K74.- Codes (February 2012)
Watch documentation to find a better option than the ICD-10 NOS code.When ICD-10-CM replaces ICD-9-CM on Oct. 1, 2013, finding a match for 571.5 (Cirrhosis of liver without alcohol) will take a bit of extra work. While most of the diagnoses you code under ICD-9 will cross directly to a matching ICD-10 code or well-defined range of codes, the corresponding codes for 571.5 aren’t as neatly arranged. Here’s a closer look at the codes that [...]
You Be the Coder: Code This Retrograde Urethrogram (February 2012)
Question: The physician performed a retrograde urethrogram with fluoroscopic interpretation. What is the correct way to report this procedure?Missouri SubscriberAnswer: Code 51610 (Injection procedure for retrograde urethrocystography) is the proper code for the surgical portion, which includes injection of contrast material into the urethral meatus in a retrograde fashion to delineate the whole urethra and bladder radiologically.You should report the radiological services for this study using 74450 (Urethrocystography, retrograde, radiological supervision and interpretation).A complete written [...]
Reader Question: 93965 Gets New Supporting ICD-9 Codes (February 2012)
Question: I saw a notice that our LCD for Noninvasive Vascular Testing (L31712) was revised. How has it changed?North Carolina SubscriberAnswer: The Palmetto GBA local coverage determination (LCD) you refer to has had multiple revisions since September 2011. Two add ICD-9 codes supporting coverage for a variety of services, while another revision takes CPT® 2012 changes into account.Effective for dates of service on or after Sept. 1, 2011, the LCD added multiple diagnosis codes supporting [...]
Reader Question: 726.73 Applies to Achilles Tendon Spur (February 2012)
Question: What is the correct ICD-9 code for Achilles tendon spur?SuperCoder.com MemberAnswer: You should report 726.73 (Calcaneal spur).The Achilles tendon is also known as the calcaneal tendon. The tendon is at the back of the heel, connecting the calf muscles and heel. A spur is a small growth of bone that can cause pain for the patient when tissue in the area becomes inflamed. X-rays can help diagnose the condition.Tip: ICD-10 2012 includes codes for [...]
Reader Question: 64622 Is for Nerve Level (in 2011) (February 2012)
Question: When billing lumbar/cervical non-pulsed radiofrequency facet denervation codes 64622/64623 (lumbar) and 64626/64627 (cervical), how should we count the services?SuperCoder.com MemberAnswer: For 2011 dates of service, you should report these codes per nerve level. As explained below, the codes have been replaced in 2012.Regarding the 2011 codes, CPT® Assistant (September 2004) explains it this way: “facet nerve destruction codes 64622-64627 [Destruction by neurolytic agent, paravertebral facet joint nerve ...] refer to individual nerve level destruction. [...]
Reader Question: Modifier 52 Solves Unilateral/Bilateral Issue (February 2012)
Question: If we perform a unilateral imaging service and the only available code specifies bilateral, should we use an unlisted code?Iowa SubscriberAnswer: Rather than using an unlisted procedure code, such as 76499 (Unlisted diagnostic radiographic procedure), you should append modifier 52 (Reduced services) to the bilateral code. Modifier 52 will let the payer know you did not perform the full service as described. Medicare supports this use in a Q&A updated Aug. 9, 2011 (search [...]
Angiographic Reconstruction Postprocessing Is Key to CTA (February 2012)
Need to distinguish CTA from CT? Computed tomographic angiography (CTA) is a non-invasive technique for imaging vessels, states CPT® Assistant (January 2007). The key distinction between CTA and computed tomography (CT) is that CTA includes reconstruction postprocessing of angiographic images and interpretation. If reconstruction postprocessing is not done, it is not a CTA study.
SI Injections: 27096 Adds Imaging, Subtracts RVUs in 2012 (January 2012)
This code’s unilateral/bilateral status is key to proper payment. Your days of choosing between arthrography and fluoroscopic guidance codes for sacroiliac injections are over. CPT® 2012 changes the definition of 27096 so that it includes fluoroscopic or CT guidance, effective Jan. 1, 2012: 2011: 27096, Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid 2012: 27096, Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed Impact: You should no [...]
