Radiology Coding Alert

Question: I noticed that CPT Codes deleted code 78990 (Provision of diagnostic radiopharmaceuticals) for 2005. What code should we use to replace it?

New York Subscriber

Answer: You won't find what you're looking for in your CPT manual. You have to look to HCPCS instead.
 According to CPT Changes 2005, you should use HCPCS Level II codes to report any diagnostic radiopharmaceuticals your radiologist documents.
 
Check the HCPCS index under "Radiopharmaceuticals" for a list of agents with specific codes. Pay careful attention to whether the code descriptor includes "per x amount" to be sure you include the correct quantity when you report the code.
 
Example: Your report indicates the physician ordered 5 millicuries of I-131 tositumomab for a Medicare patient. Report A9533 (Supply of radiopharmaceutical diagnostic imaging agent, I-131 tositumomab, per millicurie) and don't forget to note 5 in the quantity box on the CMS form.
 
Alternative: If your payer doesn't accept HCPCS Level II codes, try 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]). Be prepared to submit an invoice with this code as well, or you won't get paid.