Compliance Question of the Week – Radiology

What is the CPT® code for lung shunt fraction liver mapping? Here is part of the documentation below. There is more detail in the report but these lung shunt fraction studies for hepatic masses seem to be common.

Patient received 5.2 MCI Technetium 99M MAA. Multiple static views of the lungs and abdomen were obtained. The geometric mean of the lungs and liver were obtained. The lung shunt fraction was obtained.

Does the radiologist have to be in the room with the gynecologist while the injection and exam are performed in order for the hospital to charge the following CPT® code in the outpatient department?

74740 Hysterosalpingography, radiological supervision and interpretation

We perform treatment-simulation planning in our magnetic resonance imaging (MRI) for brain and prostate radiation procedures. The radiologist does not interpret these exams; they are performed just to send the images to other systems for their use. Is there an appropriate charge code for this type of imaging? In the past we have used 76498 but our charge-master coordinator does not think that is appropriate. Any guidance you can give is appreciated.

I keep hearing about new modifier QQ. What is this modifier used for, and is its use mandatory?

Is it appropriate to bill for a 3D post-processing charge (76377) for the computer-aided detection (CAD) portion of the prostate magnetic resonance imaging (MRI) since the computer generates a 3-D model to calculate perfusion curves?

Which code should be billed for a L5 selective nerve root block? Our radiologist doesn’t think it should be billed as a 64483 because it is not a transforaminal injection, but rather 64493.

There is no CPT® code for MRA (magnetic resonance angiography) bilateral extremity run-off, and a colleague says that we should only bill a MRA of the abdomen and MRA of both extremities. A separate code for the pelvis should not be assigned for MRA pelvis because this overlaps the abdomen and extremities. Is this correct?

When a hysterosalpingogram is performed, can 76830 and 76831 be billed if documented, or is the 76830 inclusive?

Our radiology department is removing a G-tube, but there is no CPT® code for this procedure. Is it appropriate for us to charge 99211 (office/outpatient visit established) when performed by a radiologist or technologist?

We are starting to do PET/CT for cardiac sarcoid and have some questions on what CPT® code(s) we should be using for this study. We are also thinking of doing a scan to include the whole torso to look for sarcoid evidence elsewhere in the patient. If we do that can we use the following code?

78815 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh

Instead of billing CPT® codes 71100 and 71046 together with a -59 modifier on the chest X-ray, should we bill 71101 instead?

Should we code and bill for shoulder arthrography prior to the magnetic resonance imaging (MRI) procedure?