Radiology Coding Alert

PROCEDURE CODING:

Get a Jump on CPT 2007 With These 7 Can't-Miss Updates

Don't get lost among these drastic guidance code changes Prepare to adjust your thinking -- 77xxx codes aren't just for radiation oncology anymore. CPT 2007 adds radiologic guidance, mammography, and bone and joint studies to this range of codes. Here's what you need to know. 1. Mark Up Your Mammogram Code Lists   CPT 2007 gives you new codes for breast imaging services, including screening and diagnostic mammograms, CAD, and breast MRI. You must begin using the new codes for dates of service Jan. 1 and later or risk getting denials.

See "Move Those 2006 Mammogram Codes Off Your Job Aids" in this isuue for a crosswalk to many of these new codes. 2. Toss Out Your Guidance Code Cheat Sheets Some of the codes you used daily in 2006, such as fluoro codes 75998, 76003 and 76005, now have new numbers.

Why? "Radiologic Guidance" has a new home: 77001-77032. CPT 2007 organizes the codes by fluoroscopic, computed tomography, magnetic resonance, and other guidance methods. 

So if you're coding guidance, don't make the mistake of entering the number you memorized in 2006. You need to verify the proper code number.

Example: CPT 2007 changes the codes for computed tomography and magnetic resonance needle-placement guidance, which represent two ways of accomplishing needle placement that you typically used to do under fluoroscopic guidance, says Susan Vogelberger, owner and president of Healthcare Consulting & Coding Education in Boardman, Ohio.

2006                     2007                           Descriptor
76360                  77012                         Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), RS&I
76393                  77021                         Magnetic resonance guidance for needle placement (e.g., for biopsy,needle aspiration, injection, or placement of localization device), RS&I.

Tip: Appendix M of the AMA's CPT 2007 Professional Edition crosswalks deleted 2006 codes to the new 2007 codes. 3. Add Noncoronary to 71275 To correct the problem of coders reporting coronary artery CTAs with chest CTA code 71275, CPT 2007 added the word "noncoronary" to the descriptor: Computed tomographic angiography, chest (noncoronary), without contrast material(s), followed by contrast material(s) and further sections, including image postprocessing.

A new note advises you to report Category III codes 0146T-0149T for coronary artery CTAs.

Don't miss: Another new note under 71250-71270 (Computed tomography, thorax ...) instructs you to look to 0144T-0151T for cardiac CTA, instead of using the thorax CT codes. 4. Take Time to Read New Guidelines Don't miss these two additions to the Radiology Guidelines listed before the 7xxxx code range:

• Two new functional MRI codes (70554-70555) have subsection-specific notes. If you flip to that subsection, you'll see the added instructions explain that "functional MRI involves identification and mapping of stimulation of brain function."

The instructions also explain that if a technician, non-physician, or nonpsychologist administers the neurofunctional tests, report 70554 (Magnetic resonance imaging, brain, functional MRI; including test selection and administration [...]
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