Radiology Coding Alert

Category III codes replace less specific Category I codes

July 1 has come and gone, which means you should report CT colonography with the new Category III codes 0066T and 0067T.

The AMA introduced the Category III codes earlier this year, and they became effective on July 1. The new codes 0066T(Computed tomographic colonography [i.e., virtual colonoscopy]; screening) and 0067T(... diagnostic) are the most relevant to radiology practices, says Jeff Fulkerson, BA, CPC, CMC, certified coder for the department of radiology at The Emory Clinic in Atlanta.

"We had been using the CPT Codes 74150 (Computed tomography, abdomen; without contrast material) and 76375 (Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computed tomography, magnetic resonance imaging, or other tomographic modality) for these procedures ever since Oct. 18, 2002, when CPT Assistant recommended them," Fulkerson says. Now, however, you should report the T codes instead of the Category I codes.

Rule: "If a Category III code exists for your procedure, you must use it," says Marvel Hammer, RN, CPC, CHCO, owner of MJH Consulting in Denver. You may not revert back to the prior code unless a private payer instructs you to do so.

T codes represent emerging technology, services and procedures. They may evolve into Category I codes, depending on usage, clinical efficacy, and federal Food and Drug Administration approval. After five years, the codes either graduate to Category I or receive approval to continue their status as information collectors in Category III.

Remember: T codes do not carry a relative value unit (RVU) rating. Individual payers (rather than the yearly fee schedule) determine reimbursement (and coverage) for these procedures. Nonetheless, correct coding principles dictate that you report the procedure.

For a complete list of new Category III codes effective July 1, visit www.ama-assn.org/ama/pub/article/3885-4897.html.