Radiology Question for the Week of August 23, 2021
We occasionally go to the OR to use ultrasound to assist with D&C, fetal position, lumpectomy, and other procedures. Do we use US intraoperative code 76998?
We occasionally go to the OR to use ultrasound to assist with D&C, fetal position, lumpectomy, and other procedures. Do we use US intraoperative code 76998?
If we perform a bone density on the hips and forearm can we bill both 77080 and 77081 together?
Regarding the Appropriate Use Criteria (AUC) program, CMS recently stated “Currently, the program is set to be fully implemented on January 1, 2022, which means AUC consultations with qualified CDSMs are required to occur along with reporting of consultation information on the furnishing professional and furnishing facility claim for the advanced diagnostic imaging service. Claims that fail to append this information will not be paid.” Our hospital images are read by an outsourced radiology group. Will the hospital still receive payment for the technical portion if AUC requirements are not met? Will the radiologist’s claim be completely denied?
If “MIP” is stated within the documentation, is that enough to support billing for 3D post-processing? If so, if the location that performed the Technical Component of this exam was not part of the official registry and an independent group of radiologists interpreted and billed for the professional reads for these studies is the radiology group at risk of potentially having to reimburse CMS (Medicare) for the services related to this code?
What is meant by the term, “independent workstation,” in the descriptors for CPT codes 76376, 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation, and 76377, 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation?
If the doctor did an ultrasound of the abdomen to evaluate for ascites, would that be an unlisted code or 76705? He looked at the entire abdomen but did not document the elements required for 76700.
Are we able to bill for both A9539 and A9540 radiopharmaceutical codes when a ventilation and perfusion scan is performed? Medicare is denying the A9539 code. If not, which codes should we be billing?
I am confused about an answer regarding an ultrasound arthritis survey. It has been stated that when multiple joints are imaged ipsilaterally by ultrasound to report an unlisted code. However, if the physician completes 76881 bilaterally questioning arthritis, that would be 76881-50 or RT, LT, because it is not ipsilateral. Is that your understanding as well? Is there more information that you would have on the issue that you could direct me to?
Our physician from nuclear medicine wants to charge a consult when he meets with the patients before doing leutathera treatments. He states that he has to see the patient and review their labs and make sure that the plan of care from oncology is something that the patient is able to withstand. Sometimes after the review of this information, he will change the plan of care.
I’m not sure if this visit is something that would be included with the administration of the therapy (I’m thinking the CPT would be 79101?) Do you have any input on whether a consult would be something that would be medically necessary for him to provide the treatment? He thinks it is medically necessary for him to meet with the patient and review all of their labs before he could approve their therapy. He stated that he had spent 40 minutes with the patient that he had yesterday. To me, I would think this would be included with the therapy, but I don’t find anything in writing that I can point to.
If we perform a bone density on the hips and forearm can we bill both 77080 and 77081 together?
Can you tell me the difference between codes 73040 and 23350?
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