Radiology Coding Alert

Don’t assume Medicare pays extra for bilateral guidance, too.

Cervicocerebral codes aren’t the only ones with a new bilateral indicator. Medicare also will now allow bilateral payment for unilateral code 32998 (Ablation therapy for reduction or eradication of 1 or more pulmonary tumor[s] including pleura or chest wall when involved by tumor extension, percutaneous, radiofrequency, unilateral).

Medicare is changing the Medicare Physician Fee Schedule (MPFS) bilateral indicator for 32998 from 0 (150 percent bilateral payment adjustment does not apply) to 1 (150 percent payment adjustment applies if billed bilaterally, such as with modifier 50 [Bilateral procedure]).

Effective date: The 32998 change is effective April 1, 2013, making increased payment for bilateral 32998 available for services performed April 1 or later.

Coding tips: One area to watch when reporting 32998 is that a single unit reports ablation of one or more tumors on a single side. In other words, you should report 32998 per side, not per tumor ablated.

Also, you may separately report imaging guidance and monitoring for 32998 services. CPT^® directs you to these options:

·         76940, Ultrasound guidance for, and monitoring of, parenchymal tissue ablation

·         77013, Computed tomography guidance for, and monitoring of, parenchymal tissue ablation

·         77022, Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation.

Each of the guidance/monitoring codes has a bilateral indicator of 0 (no bilateral payment adjustment) and a medically unlikely edit (MUE) of 1.