Radiology Coding Alert

Could you help me report this service?

Michigan Subscriber

Answer: You are correct that 76000 (Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time) is allowed for fluoroscopy procedures lasting up to 60 minutes. In your case, you can append modifier 22 (Increased procedural services) to 76000 to the CPT® code to indicate the service extended past the 60-minute threshold, according to CPT® Assistant, Vol. 29, Issue 9.

You should also review your payer policies for individual reporting preferences. For example, one provider may prefer you to report multiple units of 76000 rather than appending modifier 22 to the code.

During fluoroscopy, the provider passes a continuous X-ray beam through the body to visualize the patient’s internal body structures. The provider can view the images on a monitor, so the physician can evaluate the structures in real time.

Additionally, 76000’s descriptor states the service is performed separately, but you wouldn’t report the 76000 with a primary procedure code if that related procedure includes an imaging service. Examples of procedures with imaging services include:

• 33274 (Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed)
• 33275 (Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed)
• 33957 (Extracorporeal membrane oxygenation (ECMO)/ extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed))