Determine CAT Scan for Virtual Colonoscopy
Question: How should I report a virtual colonoscopy?
Minnesota Subscriber
Answer: Because no code specifically states "virtual colonoscopy," you may have to read between the lines in the documentation to figure out which computerized axial tomography (CAT scan) code to report. Depending on whether the physician performed the colonoscopy with or without contrast material, you'll choose one of the following codes:
January 2003's CPT Assistant offers further help. In this text, the American Medical Association states that when you use CPT codes to describe a virtual colonoscopy, the most appropriate codes are 74150 and 72192 (reporting the 3-D reconstruction code 76375 for the latter as applicable).
Count 20680 Once Per Ankle
Question: We had a patient come in for hardware removal from a previous bimalleolar ankle fracture. The physician made two incisions to remove the hardware, one on the medial side and one on the lateral side. Should I report 20680 two times and append modifier -59, or report the same code just once, since the work was all on the ankle?
Idaho Subscriber
Answer: Although the physician made two incisions, you should not report 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod, or plate]) twice with modifier -59 (Distinct procedural service), because that would imply that she performed two entirely separate procedures. Because only one ankle was in-volved, you should report 20680 only once, without modifier -59. If the physician removed hardware from appliances on both ankles, you would append modifier -59.
- Reader Questions reviewed by Sarah Goodman, MBA, CPC-H, CCP, president of SLG Consulting in Raleigh, N.C.
