Compliance Question of the Week – Radiology

When performing a gastrointestinal motility study that evaluates both gastric emptying and small bowel transit using dual radioisotope techniques, which factors should guide the selection of CPT® codes 78265 and 78266?

When performing a gastrointestinal motility study that evaluates both gastric emptying and small bowel transit using dual radioisotope techniques, which factors should guide the selection of CPT® codes 78265 and 78266?

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?