Compliance Question of the Week – Radiology

Whole body planar and single photon emission computed tomography (SPECT) imaging with labeled white blood cells were obtained for a clinical indication of “abdominal aortic graft in place, evaluate for possible infection.” What CPT code would be assigned?

How do I code if both FNA biopsy and core biopsy are performed at the same session on the same lesion using the same type of imaging guidance?

Both planar and single-photon emission computed tomography (SPECT) bone scan images of the lumbar spine were obtained. Would you report both 78300 and 78320?

A patient had a liver ultrasound three months ago and now we have an order for another RUQ ultrasound. Will Medicare pay for another abdominal ultrasound this soon?

Can we bill for injecting the nuclear medicine tracer Tc99m sestamibi prior to a patient having surgery? No imaging will be done, just the injection.

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?

Is the radiologist required to document details regarding the use of contrast in the final report for CT or MRI? By details, I mean name of contrast, amount given, and route of administration?

The code description for A9541 is technetium Tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries. According to the technician, when we do a lung ventilation and perfusion scan we use 50 mCi. Is it correct to code A9541 x 3?

May I report 49185 for sclerotherapy of a lymphocele?

I am in the process of setting fees up in our imaging center billing system for radiopharmaceuticals used in nuclear medicine procedures. The Medicare Physician Fee Schedule (MPFS) does not give payment amounts for radiopharmaceuticals. Do you know if and how they are paid?

May I report 78072 when SPECT and CT are performed on separate systems if using software to perform anatomic localization?

May I report code 49185 for a procedure that contains drainage prior to sclerotherapy?