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Pulmonology Coding Alert

Category III Update:

Performing Chest X-Ray With CAD? Zero In on 0152T

Published on Mon Jul 10, 2006

New computer-aided detection (CAD) technology means new codes that you have to report correctly on your first try. Here's how to give your 0152T claims their best chance at reimbursement.
 
Code +0152T (Computer-aided detection [computer algorithm analysis of digital image data for lesion detection] with further physician review for interpretation, with or without digitization of film radiographic images; chest radiograph[s]) became effective Jan. 1, 2006, less than a year after Riverain Medical debuted the RapidScreen chest x-ray CAD system. You use the code when your physician uses the chest x-ray CAD system, typically to detect early-stage lung cancer.
 
Example: The pulmonologist orders a complete chest radiological exam including at least four views and CAD with further review and digitization of the images. He discovers solid pulmonary nodules.
 
How to code: Report the x-ray views with 71030 (Radiologic examination, chest, complete, minimum of four views) and the CAD with 0152T. Report the solid pulmonary nodules with 518.89 (Other disease of lung, not elsewhere classified), unless the radiologist supplies a more specific diagnosis.
 
Code 0152T is specific to chest x-rays, not a disease, says Michael Longacre, a consultant with HealthCare Market Strategies Inc. in Yamhill, Ore.
 
Though you're most likely to use it for cancer detection now, the code is broad enough that you may be reporting 0152T in the future for detection of tuberculosis (ICD-9 codes 010-018), pneumothorax (typically 512.x), or other chest diseases, he says.
 
Tip: Code 0152T is a "carrier-priced" code. Not many insurers pay for this service. Reporting this could help to quantify the volume of the service, which could assist with future reimbursement.

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