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Medicare Compliance & Reimbursement

Your Part B Questions Answered:

Think Twice Before Reporting Dual Scans

Published on Sun Mar 14, 2010

Question: Is it appropriate to report both a CT and CTA of the same anatomic area performed on the same date? Answer: Typically, charging for both Computed Tomography (CT) and Computed Tomographic Angiography (CTA) exams of the same anatomic area on the same date is not appropriate. You should report the CTA alone. CCI support: The Correct Coding Initiative (CCI) edits bundle many CT and CTA codes for the same anatomic areas. For example, CCI bundles CT codes 70450--"70470 (Computed tomography, head or brain ...) into CTA code 70496 (Computed tomographic angiography, head, with contrast material[s], including non-contrast images, if performed, and image post-processing). These edits have a modifier indicator of "1," which means you may override them by appending a modifier to the CT code when appropriate. Rationale: Acquiring CTA data involves taking a few non-contrast images for calibration and identification followed by a full set of with-contrast CT [...]
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