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Radiology Coding Alert

Reader Question:
Sinus CT Study Has Two Options

Question: I just read that if a screening sinus CT study is performed, two options exist for charging. One choice is to use the anatomic site-specific CPT code for the area studied with modifier -52 (Reduced services). The second choice is to submit the generic, non-site-specific code of 76380 (Computed tomography, limited or localized follow-up study). Please explain what this means. My coders are thinking that if the CT sinus exam doesn't read paranasal, then they should use 70486-52 (Computed tomography, maxillofacial area; without contrast material). Colorado Subscriber Answer: Your coding team is on the right track. The reason you want to continue using 70486-52 is that this sinus screening is not a complete maxillofacial CT. Therefore, use of modifier -52 is completely appropriate. If a nearly complete procedure is performed, use modifier -52. However, if you perform a scan of a limited area within a designated body section
e.g., only doing a CT of the T11-T12 vertebral bodies
you should use 76380. Editor's reminder: The verbiage for codes 76380 and 70486 has been changed in 2003. For both codes, "computerized axial tomography" now reads "computed tomography."  


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