Radiology Coding Alert

The 8.2 version of the Correct Coding Initiative, effective July 1, 2002, contains numerous changes that can affect radiologists. Still, the edits offer no reason to panic for the savvy radiology coder, says Cindy Parman, CPC, CPC-H, co-owner of Coding Strategies Inc., an Atlanta-based firm.

Interventional coders will want to pay particular attention to the following brand-new bundling edits:

Codes 75952 (Endovascular repair of infrarenal abdominal aortic aneurysm or dissection, radiological supervision and interpretation) and 75953 (Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic aneurysm, radiological supervision and interpretation) are now bundled with:

76360 Computerized axial tomographic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation

76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation

76986 Ultrasonic guidance, intraoperative.

  Also of interest to interventional coders, CPT 75989 (Radiological guidance [i.e., fluoroscopy, ultrasound, or computed axial tomography], for percutaneous drainage [e.g., abscess, specimen collection], with placement of catheter, radiological supervision and interpretation) is bundled with:
76000 Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (e.g., cardiac fluoroscopy)

76001 Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician (e.g., nephrostolithotomy, ERCP, bronchoscopy, trans-bronchial biopsy)

76005 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint), including neurolytic agent destruction

76986 Ultrasonic guidance, intraoperative.
  All radiology coders should be aware that myelography codes also have new bundling edits. These edits cannot be bypassed with a modifier such as -59 (Distinct procedural service).   72240 (Myelography, cervical, radiological supervision and interpretation) includes 72255 (Myelography, thoracic, radiological supervision and interpretation) and 72265 (Myelography, lumbosacral, radiological supervision and interpretation)

72255 (Myelography, thoracic, radiological supervision and interpretation) includes 72265 (Myelography, lumbosacral, radiological supervision and interpretation).   Other than the above bundles, the primary focus of these edits appears to be the inclusion of anesthesia codes into radiological services, Parman says. She counts 387 new edits in this area. Radiology practices, even those whose primary focus is interventional services, are likely to feel the changes.

While anesthesia services are often provided by the radiologist in addition to the imaging and interventional services, these anesthesia services are reportable but not separately payable within the Medicare program, says Gary Dorfman, MD, FACR, [...]