Radiology Coding Alert

See what's in and what's out for radiology

It's official - the AMA has adopted the new 2005 codes reported in November's Radiology Coding Alert. But the changes aren't over. Read on to learn which radiology codes have been altered or deleted, plus one more AMA decided to add.

Ring in the New IR
 
Interventional radiologists will welcome new code 50391 (Instillation[s] of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube [e.g., anticarcinogenic or antifungal agent]). This new code will be a great replacement for the unlisted-procedure code you've been forced to use for this procedure until now, says coder Carolyn Artis with Eastern Radiology in Greenville, N.C.

Don't miss: Code 75960 has a change you need to know. The new descriptor reads: Transcatheter introduction of intravascular stent(s) (except coronary, carotid, and vertebral vessel), percutaneous and/or open, radiological supervision and interpretation, each vessel.

News Flash for Nuclear Medicine Coders

Last month you read about the new PET and PET/CT codes for tumor imaging (78811-78816). With these new additions, code 78810 (Tumor imaging, positron emission tomography [PET], metabolic evaluation) is obsolete, and you won't see it in CPT Codes 2005.

Some codes are still present, but their descriptors got a makeover for 2005. The additions are underlined:

77750 - Infusion or instillation of radioelement solution (includes three months follow-up care)

78267 - Urea breath test, C-14 (isotopic); acquisition for analysis

78464 - Myocardial perfusion imaging; tomographic (SPECT), single study (including attenuation correction when performed), at rest and/or stress (exercise and/or pharmacologic), with or without quantification

78465 - ... multiple studies (including attenuation correction when performed) ...

Read on for Radiopharmaceutical Therapy

This "section has been almost completely reworked," says Cindy Parman, CPC, CPC-H, RCC, president-elect, AAPC National Advisory Board and co-owner of Coding Strategies Inc. in Powder Springs, Ga. "In addition to new codes that are added, which classify nuclear medicine procedures by method of administration rather than by anatomic area, it is even more significant that most of the codes we have used for years are deleted." November's RCA reported three new radiopharmaceutical codes for 2005: 79005, 79101 and 79445.

Here are the radiopharmaceutical codes that the AMA changed or deleted:

CPT deleted thyroid treatment codes 79000, 79001, 79020, 79030 and 79035. You won't see codes 79100 or 79400 for intravenous injection therapies. Intravascular particulate code 79420 is deleted, too.

But remember, the new codes cover therapy and specify how it was administered (oral, intravenous, and intra-arterial particulate).

The codes with newly modified descriptors for 2005 also help you code for therapy administered by a particular method:

79200 - Radiopharmaceutical therapy, by intracavitary administration

79300 - Radiopharmaceutical therapy, by interstitial radioactive colloid administration

79440 - Radiopharmaceutical therapy, by intra-articular administration.
 
Bonus: CPT is eliminating code 79900, so the Physicians Regulatory Issues Taskforce says the final physician fee schedule rule will clarify that you can use Q3001 to bill for radioisotopes used in brachytherapy.  

Watch out: This could mean that you'll need to submit an invoice if you want to be reimbursed for the cost of the radioelements.