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Radiology Coding Alert

Bone Up on How to Code From Bona Fide Reports
Use this biopsy case study to get your AAPC continuing-education credits Learn how to nav... Read more
When Orders and Dictation Conflict, Count on These Tips
This expert strategy gets you in the money and out of the auditor's aimIf you're coding ba... Read more
News You Can Use:
AMA Confirms 2005 Code Changes
See what's in and what's out for radiology It's official - the AMA has ado... Read more
Test Yourself:
Try New Coding Skills on This Injection Procedure
Find out how your interpretation of this report matches with our experts' Test you... Read more
Reader Question:
Get an ABN for Virtual Colonoscopy
Question: Do we need to obtain an advance beneficiary notice (ABN) for virtual colonoscopy... Read more
Reader Question:
Knowing Bundles Pays Off
Question: In intensity modulated radiotherapy, is there a professional component for CPT 7... Read more
Reader Question:
Don't Always Code Symptoms Last
Question: We get a lot of radiology reports for complete carotid duplex that state weaknes... Read more
Reader Question:
Modify Related Procedures in the Global Period
Question: CPT 36870< (Thrombectomy, percutaneous, arteriovenous fistula, autogenous or n... Read more
You Be the Coder:
Organ Transplant Screening
Question: Which ICD-9 Code should I use when screening a patient before a heart transplan... Read more
Get Ready for New Endovenous Ablation Therapy and PET/CT Codes
Some of your prayers for more radiology codes could be answered soon The clock is ticking... Read more
Reporting Diagnostic Angiography? Read This First
Plus - incorporate 82 edits just for codes 76003 and 76942 The latest version of the Nati... Read more
READER QUESTION:
Diagnose Central Disk Bulge
Question: I have a report that says: Mild central disk bulge at L4-5 with facet and liga... Read more
READER QUESTION:
Interpret the ADA
Question: I have a hearing-impaired Medicare patient who insists that we provide him wit... Read more
News You Can Use:
Medicare Approves PET Coverage for AD Patients
CMS finalized the draft decision reported in October's Radiology Coding Alert On Sept. 15... Read more
READER QUESTION:
Sniff Out Reimbursement
Question: Our doctor performs a fluoroscopic "sniff" test for evaluation of the diaphragma... Read more
READER QUESTION:
Stress-Test Time Frame
Question: At our imaging center, some patients have to come back for a two-day protocol fo... Read more
READER QUESTION:
Understand Modifier -50
Question: I noticed in the October issue that you said to report modifier -50 using two pr... Read more
READER QUESTION:
Be Careful With Modifier -22
Question: Would you provide us with any information you have regarding multiplanar diagnos... Read more
You Be the Coder:
Renal Cyst Coding
Question: My radiologist did a CT-guided drainage of a renal cyst with contrast injectio... Read more
Watch Out for the OIG if You Code Mammograms Incorrectly
A Florida radiology group agreed to pay $2.53 million after being charged with billing M... Read more
Beware of This Hidden Documentation Trap
Standing orders for 3-D reconstruction can also get you into trouble  If you're codi... Read more
Use This Clip-and-Save Checklist for Unlisted-Procedure Codes
Following this careful approach can mean more accurate reimbursement If you've eve... Read more
Don't Get Distracted Coding a Stripped Fibrin Sheath
 Our experts help you through the ins and outs of this coding conundrum Scenario:... Read more
News You Can Use:
Prepare Your Front Lines for 2 Medicare Policy Changes
Proposals affect coding for diagnostic PET, therapeutic ultrasoundIf your doctor uses PET ... Read more
Carry Out ICD-9 Codes to the Most Specific Digit Possible
Relying on a 5th digit isn't always the key If you are submitting CPT Codes with t... Read more
ICD-9 Coding Success Hinges On Communication
Doctor should always approve ICD-9 codes, experts say There's a right way and a wr... Read more
You Be the Expert:
Has ICD-9 Coding Lost Its Grace?
Question: Has CMS ended the 90-day grace period for getting used to new ICD-9 Codes ? I've... Read more
Reader Questions:
Keep Up With Code Revisions
Question: For PICC line placements, our radiologist's report indicates direct sonographic ... Read more
Reader Questions:
Prevent Denials With These Modifiers
Question: I have been looking at examples showing how to code angiograms, and I noticed th... Read more
Reader Questions:
Temporary Radiologist? Append -Q6
Question: My radiology group is using a locum tenens to fill in at the hospital when someo... Read more
Reader Questions:
Don't Forget Your X-Ray 101
Question: I code for a family practice and need to know how to bill x-rays read by our doc... Read more
Reader Question:
ICD-9: You Should Claim Primary Reason as D1
Question: Should I first report the original diagnosis or the manifestation?North Carolina... Read more
You Be the Coder:
D-Dimer Diagnosis
Question: A patient was evaluated for pulmonary embolism, on a CT chest with contrast. W... Read more
Physician's Order Determines How You Should Code Patient Callbacks
Don't write off the time that your physician spends performing additional studies If your... Read more
2 Separate Ultrasounds During Same Visit? Use 2 Codes
You may be losing $$$ if you're writing off subsequent ultrasounds If you provide... Read more
Meet 3 Criteria to Bill Stent Placement With PTA Codes
Don't write off your physician's work if angioplasty of same lesion fails Suppose your in... Read more
Reader Questions:
Report Angiogram Based on Selectivity, Exam
Question: My radiologist performed an abdominal aortography and discovered no evidence of ... Read more
Reader Questions:
2 Tumors? Bill 2 Embolizations
Question: Our radiologist wants to code twice when he embolizes the right bronchial artery... Read more
Reader Questions:
Payer Preference Reigns When You Bill X-Ray, CVC
Question: According to the February 2004 Radiology Coding Alert article "NCCI Edits... Read more
Reader Questions:
3 Rib Views, No Chest, Warrants 71100
Question: We performed three views of the ribs (unilateral) with no chest involved. Which ... Read more
You Be the Coder:
Should We Append -52 to DEXA?
Question: We performed a DEXA scan on a patient's lateral spine, left hip and right hip. S... Read more
Billing G0338-G0340 With 77300? Not So Fast
NCCI 10.2 bundles scores of radiation oncology codes together, but modifiers can separate ... Read more
ICD-9 Introduces DVT, Bronchitis Codes
You have until Oct.1 to implement the new diagnosis code changes Coders, take notice: Be... Read more
Shore Up Your Zevalin Therapy Claims With 78804 or 79403
Understand the different codes for diagnostic and therapeutic procedures When your radia... Read more
News You Can Use:
New 'T' Codes Replace 74150, 76375 for Virtual Colonoscopy
Category III codes replace less specific Category I codes July 1 has come and gone, which... Read more
Clarification:
Report 49424 When You Assess Abscess or Cyst
The June 2004 You Be the Coder titled "How Should We Report a G-Tube Patency Check?" state... Read more
Reader Question:
Want Extra Pay? Keep Extra Documentation
Question: We perform daily monitoring sonograms and report CPT 76830 for them. Should w... Read more
Reader Question:
Include Pressure Measurement With Catheter
Question: Our radiologist performed a selective catheterization of the renal artery and a... Read more
Reader Question:
Note Subtle Differences Between 32020 and 32002
Question: How can we distinguish 32002 from 32020? We confuse these two codes all the ti... Read more
Reader Question:
Obtain History From Patient as Exception, Not Rule
Question: In the June 2004 article "ICD-9 V71.89 : It's Not a Quick Radiology I... Read more
Reader Question:
Medicare Accepts G0254; Private Payers Prefer 78810
Question: My insurer denied a claim when we reported G0254. The payer requested that we ... Read more
You Be the Coder:
Should We Report 47382 for Alcohol Ablation?
Question: Our radiologist performed an ultrasound-guided alcohol ablation of a liver cys... Read more
4 Field-Tested Tips Improve Your Peripheral Artery Ultrasound Coding
Know 93922's and 93923's requirements to determine when you can ethically report... Read more
Think Carriers Bundle Gadolinium Into Brain MRIs? Think Again
Hint:Third time's the charm for A4647 reimbursement If your radiologist's brain MRI docum... Read more
HCPCS Codes May Be the Key That Unlocks Your Radiology Supply Reimbursement
Don't write off your radiology supply code reimbursement if your practice purchased ... Read more
'Unusual'Procedure? Modifier -22 Can Gain Reimbursement
If your services exceed the procedure code description,append modifier -22 As long as your... Read more
Reporting Related Codes? Use Mods -59,-51 To Keep Claims Clear
Use mod -59 for procedures you don't normally report together When your radiologis... Read more
You Be the Expert:
2 CT Scans In 1 Session
Question: Our radiologist performed a head CT scan and a temporal bone CT scan in the sa... Read more
Reader Question:
Two Babies, One Transvaginal Ultrasound Code
Question: How should I report a transvaginal ultrasound for a patient pregnant with twins... Read more
Reader Question:
Saphenous Vein Ablation Warrants Unlisted Code
Question: Our radiologist performed a direct puncture ablation of the saphenous vein. Sh... Read more
Reader Question:
Report 73050 Only Once Per Session
Question: I understand that CPT 73050 reads,"with or without weighted distraction." Whe... Read more
Reader Question:
36215-59 Covers Two Arteriograms
Question: Our radiologist performed a left brachial approach carotid/cerebral arteriogra... Read more
Reader Question:
HCPCS Code Covers Miraluma Breast Scan
Question: Is a Miraluma breast scan an ultrasound breast procedure? Our radiology departm... Read more
Reader Question:
Don't Let Brand Names Guide Your Catheter Coding
Question: Which codes should we report when the radiologist inserts the following vascula... Read more
Reader Question:
Check CPT For Mod -51 Exemptions
Question: Do you have to use -51 modifier every time you code a visit where the radiologi... Read more
You Be the Coder:
Multiple Modifiers Apply to RS&I Code Without Supervision
Question: Our radiologist often reads the films for intraoperative carotid ultrasounds, ... Read more
Coding Quiz:
Think You Can Select the Correct Code for 'Simple' Radiology Procedures?
The answers might surprise you If you think coding biopsy and rib x-ray reports is a ... Read more
V71.89:
It's Not a Quick Radiology ICD-9 Fix
The observation code may bring in over $160, but it isn't always appropriate Although V71... Read more
5 Tips Help You Choose Among Modifiers -58, -78 and -79
How to collect for services you perform during the global period If your interventiona... Read more
Reader Question:
76370 Includes Professional Component
Question: Our physician documented "CT radiation therapy planning." How can we report this... Read more
Reader Question:
Look to 756.12 for Anterolisthesis Dx
Question: Can you direct us to the ICD-9 Code for anterolisthesis? Mississippi Subscr... Read more
Reader Question:
2 Breast Lesions? Use 2 Codes
Question: We recently performed stereotactic local-ization and biopsy on two right breast ... Read more
Reader Question:
Don't Bill Surgical Supplies for Office Procedure
Question: We are having trouble collecting reimbursement for the supplies that the inter... Read more
Reader Question:
Adrenal Biopsy? Look to 49180 or 10021
Question: How should we report a CT-guided needle adrenal mass biopsy?Missouri Subscriber ... Read more
Reader Question:
Select U/S Code According to Gestation
Question: We performed an obstetric ultrasound on a patient who was 17 weeks pregnant. The... Read more
3 Tips to Improve Selective Vascular Cath Coding
Bilateral procedure)." Helpful hint: Check with your carrier for modifier guidel... Read more
NCCI 10.1 Deletes Transvaginal, Pelvic Ultrasound Edit
Edit deletion could bring your practice up to $120 more than beforeRadiology coders can fi... Read more
You Be The Coder:
How Should We Report CTA Chest?
Question: How can we get Medicare to reimburse a computed tomography angiogram (CTA) of ... Read more
Mammography Update:
Re-Count the Months Between Screening Mammograms
In our April article "Performing DEXA or Mammography Too Often? Prepare an ABN," Radiolog... Read more
Reader Question:
Look to 78267 for Urea Breath Testing
Question: One of our physicians documented "urea breath testing." How should we report thi... Read more
Reader Question:
Avoid 'S' Codes When Billing Medicare
Question: I read your March article "No Code? No Problem" regarding unlisted-p... Read more
Reader Question:
Append Modifier -53 to Discontinued Procedures
Question: I administered a digital mammogram to a patient, but she could not tolerate the ... Read more
4 Answers for Your SPECT Bone Procedure Coding Questions
If you assume that CPT 78306 is bundled into 78320, you could be writing off $115 per pa... Read more
Clip and Save Chart:
Know Your Bone-Scan Code Pairs
Use this nuclear-medicine code crosswalk to save time and cut denials If your practice has... Read more
Performing DEXA or Mammo Too Often? Prepare an ABN
Don't write off the $100-$150 that Medicare allots for 76092 and 76075If you're researchin... Read more
News You Can Use:
Medicare Nearly Doubles Ophthalmic A-Scan Pay
CMS' fee schedule update increases pay for several radiology proceduresIf Medicare's 2004 ... Read more
Coding Update:
Say Farewell to NCCI's CVC Guidance Edit
The edit that bundled 76937 and 75998 was short-lived but caused quite a stir Althou... Read more
Get ABNs, or Risk Picking Up Patient Tabs
Without ABNs, unpaid Medicare bills may become your problemIf you aren't obtaining advance... Read more
ABNs:
What to Change, What to Leave Alone
Got an itch to make a switch on an ABN? Proceed with cautionWhen it comes to manipulation ... Read more
You Be The Expert:
ABNs and Uncovered Medicare Services
Question: Our office obtains advance beneficiary notices each time there is some doubt abo... Read more
Reader Question:
You Can Pair 73580 With 27370
Question: When we perform supervision and interpretation for knee arthrography, can we als... Read more
Reader Question:
Ask the Doctor to Choose Enteroclysis Tube Code
Question: Our radiologist inserted an enteroclysis tube. How should we report this service... Read more
Reader Question:
Report 76360 for CT Guidance During Biopsy
Question: Our practice performed CT guidance during a liver biopsy. How should we report o... Read more
Reader Question:
Ask Your Payer How You Should Report CT Cardiac Scoring
Question: How should we report CT cardiac scoring? We would like to bill for the professio... Read more
Reader Question:
Follow the CMS Definition of 'Deliver'
Question: Since the purpose of an ABN is to inform the patient about a service, our office... Read more
You Be The Coder:
How Should We Report Knee X-Rays?
Question: We performed an upright weightbearing AP view of both knees, and the coder assig... Read more
Reporting 70371 for Swallowing Studies? Expect a Call From the OIG
The pharyngeal evaluation code might get you 63 percent more money, but it could also brin... Read more
Improve Your Brachytherapy Planning Pay in 4 Steps
Experts show how to select consult, isodose and treatment planning codesThe next time your... Read more
No Code? No Problem:
3 Steps to Reimbursement for Unlisted Procedures
It's your practice's job to recommend an appropriate fee If you perform a pro... Read more
Coding Quiz:
Screening or Diagnostic? Test Your Mammogram Coding IQ
Hint: Asymptomatic patients' mammograms are usually 'screening'Think your mammogram coding... Read more
You Be The Coder:
How Should We Report a Normal Ultrasound?
Question: What is the ICD-9 Code for a normal breast ultrasound? Vermont Subscriber ... Read more
Reader Question:
G-Tube Supplies Might Require DME Number
Question: Do we need a durable medical equipment (DME) number to bill gastrostomy tube rep... Read more
Reader Question:
Check Orders Before Reporting MRI
Question: A neurosurgeon referred a patient to our independent diagnostic testing facility... Read more
Reader Question:
You Can Still Report A4644-A4646
Question: I was surprised to see that HCPCS Codes deleted the low osmolar contrast mater... Read more
Reader Question:
Report 76090 for Unilateral Spot Compression
Question: Which code should we report for a unilateral spot compression? Our consultant re... Read more
NCCI 10.0 Targets the New Central Venous Access Codes
Medicare won't pay both US and fluoro guidance with new CVC codes - unless you append a mo... Read more
News You Can Use:
Higher Conversion Factor Increases Radiologists' Pay
CMS finally released the long-awaited 2004 conversion factor. According to CMS' Dec. 24 tr... Read more
Debunk 3 Common Radiology Diagnosis Coding Myths
Don't let these coding errors sink your claims You assigned the correct CPT Codes ... Read more
When Your Radiologist Vacations:
Modifiers -Q5 and -Q6 Keep Reimbursement Coming
2 scenarios show you how to report stand-in services and get paid  When your rad... Read more
Clip-and-Save Checklist:
11 Tips for Recouping Payment for Substitute Physicians
You can avoid unnecessary stress during physician vacations when you report reciprocal bil... Read more
Reader Question:
Count Self-Referrals as Office Visits
Question: A patient with back pain came to our office to determine whether she is a candid... Read more
Reader Question:
See Modifier -55, Think Postoperative Care
Question: Our interventional radiologist recently took over the postoperative care of anot... Read more
Reader Question:
New Cath Repair Code Refers to Hub Repair
Question: Our patient's permanent catheter had a cracked clamp and hub on the arterial por... Read more
You Be the Coder:
Is There a HIDA Scan Code?
Question: What code should we report if the physician documents a "HIDA scan"?Colorado Sub... Read more
Mammography CAD Code Update:
Beware - Your Carrier Might Not Honor the Grace Period for New CAD Codes
Because most insurers offer a three-month grace period before you must begin reporting n... Read more
3 Tips for Reporting the New CV Access Codes
Think age doesn't matter? New CV access codes say otherwise CPT Codes 2004 includ... Read more
CPT Clears Up Cloudy Starred Procedures
Don't let deleted 'stars' disrupt your private-payer claims   The AMA... Read more
Fee Schedule Update:
Physicians Escape 4.5 Percent Cut for 2004
Medicare legislation raises conversion factor by 1.5 percent CMS offered radiologists an e... Read more
Restructure Appeals With These 6 Steps
Get organized for easier, more productive appeals When your practice receives a denia... Read more
Read EOBs Before Responding to Denials
What 'noncovered service' really means to your office You can't streamline... Read more
Reader Question:
Report 76098 for Specimen X-Rays
Question: When should I report CPT 76098 ? Should it be used when x-rays are taken of the ... Read more
Reader Question:
Report 92950 for Resuscitation
Question: Our interventional radiologist was making rounds at the hospital today when he r... Read more
Reader Question:
Choose 36005 for Extremity Venography
Question: Our radiologist performed a left upper-extremity venogram with contrast into the... Read more
Reader Question:
Bridge the Communication Gap ASAP
Question: The physicians and billers in my office don't practice open communication, and i... Read more
You Be the Coder:
Should We Report Cancer Diagnosis?
Question: We sometimes perform tests on patients who are in cancer remission. When shoul... Read more