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Radiology Coding Alert

NCCI Update:

Stop CT/CTA Coding Slipups

Published on Wed Apr 19, 2006

Add these version 12.1 edits to your Category lll CTA code toolbox

Don't let the latest National Correct Coding Initiative edits keep you from reporting both CTs and CTAs when justified. We'll show you how.

Check out these new edits:

These edits have a modifier indicator of "1," so you can override them with an appropriate modifier.

But watch out. "You're not supposed to be doing a CT of the chest as well as a CTA of the chest," says Jeff Fulkerson, senior certified coder in the radiology department at Emory Health Care in Stockbridge, Ga. "Those should be few and far between."

Example: You may be able to break the edit in the following situation: The physician performs an exam (such as 0148T) targeting cardiac sources of symptoms. The exam doesn't substantiate a diagnosis but suggests that non-cardiac causes may be to blame, so the patient needs a full non-cardiac chest CT (such as 71275) for characterization.

Watch for: The clinical history leading to the two different examinations should substantiate medical necessity and the use of appropriate modifiers to override the NCCI Edits .

You can download the full list of edits at www.cms.hhs.gov/NationalCorrectCodInitEd/.

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