Radiology Coding Alert

Plus: Discover how limited ultrasound edits help perfect your bladder coding.

Before you get too excited about seeing spine x-ray codes among Correct Coding Initiative 15.1 edit deletions,be sure you get the facts.

Bonus: These edits, effective April 1, alert you to whether youve been coding services correctly in the past.

Replace Old Spine Coding Edits With New

New: CCI 15.1 creates the following spine x-ray column 1/column 2 edits and gives them a modifier indicator of 1:

This is a column and category switch for these codes.

Deleted: CCI 15.1 deletes the previous mutually exclusive edits, which had 72010 in the column 2 position:

Helpful: You should code 72010 only when it is a stand-alone exam -- or if it is intended to be a stand-alone but abnormal findings make more views necessary, says Jackie Miller, RHIA, CCS-P, CPC, vice president of product development for Coding Metrix Inc. in Powder Springs, Ga.

But a stand-alone 72010 isnt routine. Usually an emergency physician has ordered a full exam of one or more spinal regions, Miller says.

Support: Miller cites the ACRs Radiology Coding Source (March-April 2008): If the original intent is to complete the spine exam at each level (particularly in the cervical and lumbar spine where obliques are routinely done), then AP and lateral views to clear the spine and to allow the technologists to move the patient for the oblique or other views should not be separately coded as these will be part of the final complete four-to seven-view exam.

Tame Your 76857/76775 Temptation

CCI bundles 76857 (Ultrasound, pelvic [nonobstetric], real time with image documentation; limited or follow-up [e.g., for follicles]) into 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real time with image documentation; limited). This edit also has a modifier indicator of 1.

Good news: Youre unlikely to ever need to report these two ultrasound codes together, so this edit will simply help keep your claims accurate.

Keep in mind: If you image the bladder as part of a complete urinary tract ultrasound, payers consider it a retroperitoneal exam (76770, & complete); but if you image the bladder by itself, you should report a limited pelvis (76857), Miller says. The edit will help avoid the temptation to bill a higher-paying urinary tract exam as 76775 + 76857 instead of 76770.