Compliance Question of the Week – Radiology

When, if ever, is it appropriate to bill a chest CT (with or without contrast) as well as a CTA on the same date of service? What if there are two clearly independent indications and independent physician orders?

Can you clarify the requirements for concurrent supervision for 3D reconstruction CPT codes 76376 and 76377?

What is the correct way to bill 76881 when imaging bilateral hands and feet? We get denials when we bill it in units. When we bill it as 76881-RT, 76881-LT, 76881-59-RT, 76881-59-LT, we get a denial for frequency. I researched and found that we can bill up to four times in one encounter. Is the coding correct? Has the frequency changed?

We performed a kidney flow and function scan. Twenty minutes into the scan, Lasix was administered, and the imaging continued. Would we assign code 78708 or 78709?

Does Medicare have a MRI coverage policy for cardiac-related electronic devices?

What is the correct way to code cases that involve patients who are having a multi-day nuclear medicine test, such as a two-day cardiac stress test in an outpatient setting (hospital-based)? Sometimes, but not frequently, we’ll have a patient come for the rest portion and then come on a second day for the stress portion of the test.

I would like a second opinion on billing for a limited extremity ultrasound (US) and an aspiration with US guidance. These are documented on the same report without separation. I feel that although the criteria for a limited 76882 are met (i.e., imaging of the joint and showing effusion), the procedure is really performed for needle placement, which would make it inclusive. Could you please review the report below and give me your opinion?

What would be the code when a physician performs selective angiography of the anterior and posterior superior pancreaticoduodenal artery?

Do insurers require an inconclusive SPECT myocardial perfusion scan prior to performing a PET myocardial perfusion scan?

Would I report 49400 and 74190 for a peritoneal dialysis catheter check?

One of our patients had a lung ventilation-perfusion scan with SPECT/CT Imaging. How is this coded?

We received an order for a computed tomography (CT) of the right ankle without contrast material and a CT of the right foot w/o on the same patient. Can we charge for both procedures separately if we separately scan each part? I know they both use the same CPT® code 73700 (CT, lower extremity; without contrast material). If we were to scan the entire region (toes to mid leg) in one scan I assume in that case we would only charge 73700 one time.