Radiology Question for the Week of November 11, 2024

In reference to your answer to General Question for the Week of February 5, 2024 [Can imaging guidance for central venous access catheter or device placement be separately reported?], you stated that 76937 and 77001 may be assigned as long as they are documented properly. This appears to conflict with the NCCI manual narrative instruction – 12. Radiological supervision and interpretation codes include all radiological services necessary to complete the service. CPT® codes for fluoroscopy/fluoroscopic guidance (e.g., 76000, 77002, 77003) or ultrasound/ultrasound guidance (e.g., 76942, 76998, 76937) shall not be reported separately. CPT – 77001 – Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure). Can we assign 77001 and 76937 for a CVC or not?

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Cardiology Question for the Week of November 11, 2024

Which CPT® code would a hospital bill if an inpatient has a PICC placed, but after multiple attempts and repositioning, the surgeon cannot pass the PICC line, which is positioned in the internal jugular vein near its junction with the subclavian vein? Context: The skin is anesthetized with lidocaine, and the brachial vein is accessed to insert the line. Multiple attempts to reposition the line were performed with chest x-rays after each repositioning. The line did not terminate in the subclavian, brachiocephalic, or iliac vein, SVC, IVC, or right atrium. The surgeon wants the hospital to charge CPT codes 36573 and 76937, which are incorrect.

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Radiology Question for the Week of November 4, 2024

The speech pathologist is in the room with the radiologic technologist who operates the fluoroscopy for the procedure sometimes there is a radiologist present in the room and other times there is not. Can the hospital bill for 74230 (TC)?

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Cardiology Question for the Week of October 28, 2024

How would you code a procedure where the physician selectively catheterizes the internal carotid artery and performs intracranial carotid imaging, along with imaging of the arch and extracranial carotid arteries, and then selectively catheterizes the internal carotid artery on the opposite side with intracranial imaging?

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