Radiology Coding Alert

NCCI 13.1 takes aim at RF, CCTA, and AAA Speed up learning how National Correct Coding Initiative 13.1 affects radiology with this at-a-glance chart.
 You'll quickly spot the edits that affect you most with this analysis from radiology coding expert Jackie Miller, RHIA, CPC, senior coding consultant for Coding Strategies Inc. in Powder Springs, Ga.
RADIOFREQUENCY ABLATION

NCCI 13.1 bundles the following procedures into the code for percutaneous radiofrequency ablation of renal tumors (50592):
 
 • Fluoroscopy (76000, 76001, 77002)
 
 • Ultrasound guidance (76942, 76998)
 
 • CT guidance (77012)
 
 • MR guidance (77021)

Helpful: Report guidance for renal tumor ablation with 76940 (ultrasound), 77013 (CT), or 77022 (MR) rather than the codes listed above.
 NCCI 13.1 bundles cryoablation of renal tumors (0135T) into radiofrequency ablation (50592).

CCTA

The following procedures are bundled into the Category III codes for CCTA (0144T-0150T):
 
 • Anesthesia (01916, 01922)
 
 • EKG (93000, 93005, 93010)
 
 • Rhythm strip (93040, 93041, 93042)
 
Watch for: You can't override the anesthesia edit with a modifier (modifier status 0).
 
Venous catheterization (36000) and venipuncture (36410) are bundled into the codes for CCTA with contrast (0145T-0150T).

Rationale: CCTA includes cardiac gating, so you should not be charging separately for an EKG or rhythm strip.

AORTIC ANEURYSMS

The new HCPCS code for screening for abdominal aortic aneurysm (G0389) is bundled into the following:
 
 • Abdominal duplex exam (93975, 93976)
 
 • Duplex of aorta (93978, 93979)
 
 • Retroperitoneal ultrasound (76770, 76775)

Tip: Code G0389 and 76775 (limited retroperitoneal US) are mutually exclusive while G0389/76770 (complete retroperitoneal US) is a nonmutually exclusive edit. Reason: Screening for AAA (G0389) is a limited retroperitoneal ultrasound exam reported with its own G code to show that you performed it for screening purposes.
 
Intraoperative ultrasound (76998) is bundled into AAA screening (G0389).
 
The following procedures are bundled into placement of a wireless physiologic sensor during endovascular repair of aortic aneurysm (0153T):
 
 • Ultrasound (76942, 76998)
 
 • Fluoroscopy (76000, 76001, 77002)

Tip: This edit reflects 0153T includes radiological supervision and interpretation.

ENDOVENOUS ABLATION

Intraoperative ultrasound (76998) is bundled into endovenous ablation of incompetent veins (36475, 36478). 

Remember: Endovenous ablation includes "all imaging guidance" by CPT definition.

GYNECOLOGICAL SERVICES

Transvaginal ultrasound (76830) is bundled into saline infusion sonohysterography (76831).

Note: See "Don't Miss Legit Chances to Override These Hard-Hitting IVR Edits" on page 33 and "Take the SRS Bull by the Horns: Collect $600" on page 36 for more information on how NCCI 13.1 affects you.