Part B Insider (Multispecialty) Coding Alert
Reader Question:
Know When 1 Code Covers 8 Views
Published on Thu Oct 04, 2012
Question:
Answer:
Assuming documentation indicates bilateral views, you should report a single unit of 70330 (Radiologic examination, temporomandibular joint, open and closed mouth; bilateral). If the imaging was unilateral you would instead report 70328 (... unilateral).As CPT® Assistant (May 2011) explains, "the code descriptor does not specify the number of views." So a single unit of 70330 is sufficient to report bilateral TMJ imaging with the mouth open and closed regardless of the number of views.
Additionally, CMS lists a Medically Unlikely Edit (MUE) of 1 for 70330. That means that if you report more than one unit of 70330 on a claim line, the line will be denied.
Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- RAC Audits:
One RAC's Decision to Audit E/M Claims Draws Fire
Connolly becomes the first RAC to focus on E/M inaccuracies.Recovery audit contractors (RACs) have reviewed [...] - Compliance:
OIG to Focus on E/M, Incident-to, and Global Modifiers in 2013
Plus: You'll also see extra scrutiny on anesthesia and ophthalmology claims, among others. The HHS [...] - Electrical Stimulation:
Know the Specifics When Coding H-Wave Studies
Keep Stark laws in mind when the physician dispenses the device. The differences between 'H' [...] - Part B Mythbuster:
No 'Standard' Code Applies to Specialty E/M Services
Select the appropriate code based on the documentation--not the specialty or diagnosis.When it comes to [...] - Reader Question:
99232 Isn't Appropriate for Every Hospital Follow-up
Question: The anesthesiologist placed an indwelling thoracic epidural catheter at T6-T7 for a patient with [...] - Reader Question:
Medicare Won't Reimburse Extra for Modifier 33
Question: Some of our payers deny claims with modifier 33 because they state the modifier [...] - Reader Question:
Dosage Size Doesn't Dictate 'Prescription Strength' MDM
Question: I have a provider who has stated that if he recommends that a patient [...] - Reader Question:
Use Different Rules for Same-Day Visits
Question: We had a patient with a hiatal hernia who saw one surgeon in our [...] - Reader Question:
Unlisted Codes May Require Extra Notes
Question: Our gastroenterologist recently performed a laparoscopic procedure on a patient with lymphoid hyperplasia of [...] - Reader Question:
Know When 1 Code Covers 8 Views
Question: I've got a report for eight TMJ views with the mouth in a variety [...] - Physician Note:
Vaccines Receive Booster Shots for 2013
Plus: Consider these lab tests officially 'CLIA-waived.'Good news for physicians who administer flu shots -- CMS [...]
View All
