Radiology Coding Alert

See if this CMS announcement changes your screening claims

Add one more bullet to your list of mammogram coding rules.
 
You should report the screening mammogram diagnosis code (V76.11 or ICD-9 V76.12 ) as a secondary diagnosis if you report services other than screening mammogram on the claim, effective Oct. 1. Read up on the rule at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5050.pdf ("Correct Reporting of Diagnosis Codes on Screening Mammography Claims").
 
In other news: CMS created a new carotid stent section in the Medicare Claims Processing Manual (publication 100-04, The Medicare Claims Processing Manual, Chapter 32, Sections 150.1-150.3). The section includes information about PTA for implanting the carotid stent. Find out more at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5022.pdf ("Clarification on Billing Requirements for Percutaneous Transluminal Angioplasty [PTA] Concurrent with the Placement of an FDA-approved Carotid Stent").
 
Key point: Medicare won't cover 37216 (Transcatheter placement of intravascular stent[s], cervical carotid artery, percutaneous; without distal embolic protection). Medicare requires distal embolic protection for coverage.
 
And you don't need to get worked up over Transmittal 923 (CR 5054), which refers to "two new radiopharmaceutical codes": A9555 (Rubidium Rb-82, diagnostic, per study dose, up to 60 millicuries) replaces Q3000, and A9552 (Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 millicuries) replaces C1775.
 
These codes actually took effect Jan. 1 but were mistakenly not added to the Claims Processing Manual till now. (www.cms.hhs.gov/transmittals/downloads/R923CP.pdf)