Radiology Coding Alert

Coding Quiz Answers:

Check Your Answers to Our Coding Quiz

Published on Wed Dec 21, 2022

How much do you know about the 2023 CPT^® coding changes?

Do you think you nailed every answer from our quiz questions on page 3? Check your work to see if your answers match up with the ones provided below.

Recognize How to Code a Neuromuscular Extremity Ultrasound

Answer 1: You’ll assign 76883 (Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity) to report the ultrasound of the patient’s left arm.

Code 76883 is a new addition to the CPT^® code set as of Jan. 1, 2023. The code is reserved for reporting a real-time, complete neuromuscular ultrasound of the patient’s extremity nerves and accompanying structures. The physician must evaluate the entire anatomic course of the patient’s extremity for you to assign 76883.

According to the AMA CPT^® guidelines prior to the Extremities codes of the Diagnostic Ultrasound section in the code set, the documentation for 76883 should include “the acquisition and permanent archive of cine clips and static images to demonstrate the anatomy.”

Focus on the Revised Limited Ultrasound Descriptor

Answer 2: You’ll assign 76882 (Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation) to report the limited ultrasound of the patient’s right knee joint. This code is designated for a limited evaluation of a patient’s joint or a focal evaluation of a patient’s body structure, other than a joint, in any extremity. Body structures that are not joints include nerves, fluid collection, and soft-tissue masses.

Effective Jan. 1, 2023, 76882 now includes the wording “focal evaluation of” in its descriptor. The addition of “focal evaluation of” further specifies how 76882 is a limited exam of a nonvascular extremity structure.

“Regarding the limited joint code and the complete ultrasound code (76881 Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation), the [Relative Value Scale Update Committee (RUC)] notes that ultrasound technology has evolved immensely since the code was valued in 2010,” says Grabiela Juarez, CPC, CPMA, COC, AAPC Approved Instructor, revenue cycle specialist for Sceptre Management in Salt Lake City, Utah. The evolved ultrasound technology includes the increased use of high-frequency ultrasound probes that providers use to image the musculoskeletal system. These probes produce high-fidelity images with exceptional detail.

Providers can use 76882 to evaluate patients with an acute injury and triage for urgent surgical intervention or conservative physical therapy.

According to the AMA CPT^® guidelines, a limited evaluation of a joint “includes assessment of a specific anatomic structure(s) that does not assess all of the required elements included in 76881.”

At the same time, the provider’s written report must contain the following:

Descriptions of each body structure evaluated during the procedure
Permanently recorded images

The 2023 CPT^® code set also features a parenthetical note under 76882 instructing you to not report this code with 76883.

Acquire Revised Descriptor Knowledge for 2023

Answer 3: This question had multiple components, so we’ll tackle them one by one.

The tumor localization codes revised for the 2023 CPT^® code set are as follows:

78803 (Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging)
78830 (… tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/ detection of pathology, single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging)
78831 (… tomographic (SPECT), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days)
78832 (… tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/ detection of pathology, minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days)

When you review the revised descriptors of 78803 and 78830-78832, you’ll notice two words that are new as of Jan. 1, 2023. That’s right, the phrase “or acquisition” was added to each of these code descriptors.

“The reason why it was important to include ‘or acquisition’ is because this involves separately obtained image sets with two different radiopharmaceuticals. That is why it was important to include it in the code descriptors,” said Rae Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CCS, senior vice president of products at AAPC in her “2023 CPT^® Coding Updates” webinar.