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Radiology Coding Alert

Tighten Up Your Claims:
CPT 2004 Brings Debut of 22 Catheter, Line Placement Codes

Radiology coders, rejoice: CPT 2004 completely revamps the catheter and line placement access codes, resulting in greater specificity and less confusion. CPT also adds new codes for mammography, brain MRIs, tumor localization, Zevalin therapy, and fluoroscopy in its 2004 edition.
 
"The biggest relief is that CPT Codes finally revised the line placement codes," says Paulette B. Stone, CPC, RCC, quality assurance specialist at Public Employees Health Program, a nonprofit health program in Utah. "The ability to report these services correctly will greatly improve the reimbursement in any interventional radiology department."
 
A sampling of the new catheter insertion and line placement codes (36555-36597) is listed in our article "The New Codes at a Glance" on page 83. To make way for the new codes, CPT 2004 deletes catheter placement codes 36488-36493 and codes 36530-36537. "We had memorized a lot of the codes that are now being deleted, so remember to look closely at CPT 2004 to select the right PICC line and tunneled catheter codes," says Kay Tracy, BS, RCC, lead coder at the Oregon Clinic's radiology department.
 
"We were accustomed to choosing codes according to patient age and between non-tunneled or tunneled lines," Tracy says. "The new codes further break down the procedures by insertion site (central or peripheral), use of subcutaneous port or pump, and use of one or two catheters/access sites."
 
The new level of specificity will require radiologists to dictate and document their services more carefully than ever so coders can select the most accurate code. Fluoroscopy Codes Revamped CPT 2004 includes a new fluoroscopic guidance code to use with the central line placement codes - 75998 (Fluoroscopic guidance for central venous access device placement, replacement [catheter only or complete], or removal [includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position] [list separately in addition to code for primary procedure]).
 
CPT also adds code 76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting [list separately in addition to primary procedure]).
 
"These will be more explicit than the guidance codes we previously used," Tracy says. "Hopefully, the new codes will help physicians receive adequate credit for the work they do." Get Specific With New IR Codes CPT 2004 introduces a new bone tumor ablation code, 20982 (Ablation, bone tumor[s] [e.g., osteoid osteoma, metastasis] radiofrequency, percutaneous, including computed tomographic guidance). "This is really going to [...]