Radiology Question for the Week of November 18, 2024
What code do we report if a dual-radiopharmaceutical technique is utilized to obtain both solid and
liquid-phase studies in the same session or on the same day?
What code do we report if a dual-radiopharmaceutical technique is utilized to obtain both solid and
liquid-phase studies in the same session or on the same day?
In reference to your answer to General Question for the Week of February 5, 2024 [Can imaging guidance for central venous access catheter or device placement be separately reported?], you stated that 76937 and 77001 may be assigned as long as they are documented properly. This appears to conflict with the NCCI manual narrative instruction – 12. Radiological supervision and interpretation codes include all radiological services necessary to complete the service. CPT® codes for fluoroscopy/fluoroscopic guidance (e.g., 76000, 77002, 77003) or ultrasound/ultrasound guidance (e.g., 76942, 76998, 76937) shall not be reported separately. CPT – 77001 – 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). Can we assign 77001 and 76937 for a CVC or not?
The speech pathologist is in the room with the radiologic technologist who operates the fluoroscopy for the procedure sometimes there is a radiologist present in the room and other times there is not. Can the hospital bill for 74230 (TC)?
What is your advice on the assignment of 76937 with another RS&I code after reviewing the NCCI narrative for 2024?
CMS recently approved coverage of PET scans of the brain to assess for dementia/Alzheimer’s/amyloid. We do the exams using CT attenuation correction. There has not been any specific guidance issued on which CPT® code to use and there’s debate on whether to use 78608 or 78814 (or possibly something else). Can you recommend which CPT to use when performing the exams? We’re in Massachusetts and have not seen an LCD issued yet.
My radiologist is reading an MRI Prostate and 3D reconstruction. My question is can we bill for the 3D? My understanding is that there should be an order from referring MD for the 3D. Also what type of reporting needs to be documented for the 3D. We are just billing for the professional component using modifier 26 as he is independent from the facility/IDTF where performed.
Can or should a radiologist bill for both 74320 and 92611? My understanding is that 92611 is typically billed by a speech pathologist, but I would appreciate confirmation or clarification. Since the code refers to a ‘motion fluoro’ study using ‘cine or video recording,’ I’m unsure whether a speech pathologist would have the necessary equipment to perform this exam
I have a question in regards to hospital (TC) billing for a code in question 74230. Is the hospital allowed to bill for 74230 if the radiologist is not present or in the room for the procedure?
When coding a US retroperitoneal Complete for US kidneys ureters bladder, my sonographers tell me that nine times out of ten, the ureters in most patients are not visible unless there is hydronephrosis. If we image the kidneys and bladder but the ureters are not seen and charge a complete, should the radiologist dictate ureters are not visualized so we can charge a complete (code 76770)?
Can I code an abdomen complete ultrasound (76700) and an elastography ultrasound (76981) on the same date of service?
Is a physician’s prescription required for Medicare to cover a screening mammography?
Is there a guideline that states that patients with a history of mastectomy must revert to a screening mammography study after a set number of negative diagnostic studies or after a specified number of years post-mastectomy?
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