Compliance Question of the Week – Radiology

Is there a more appropriate CPT code than 77067 with an add-on code of 77063 for a screening mammogram with tomosynthesis for a patient who has had a unilateral mastectomy?

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?

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?

How do you code for a screening mammogram when additional magnification views are required for a suspected abnormality? May I code both a diagnostic mammogram and a screening mammogram?

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?