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:

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:

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).

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, FSCVIR, president of Health Care Value Systems in North Kingstown, R.I. But other payers may pay for these anesthesia services.

Example:

CPT Code 70540 (Magnetic resonance [e.g., proton] imaging, orbit, face, and neck; without contrast mater-ial[s]) includes 01922 (Anesthesia for non-invasive imaging or radiation therapy).

A second area of interest encompasses intraoperative ultrasound (76986, Ultrasonic guidance, intraoperative), which will now bundle into other radiological procedures.

Examples include:

CCI 8.2 includes still more bundling of 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) into other radiological services, with a modifier status of "1." Examples include: