Radiology Coding Alert

Question: I code for the hospital radiology department. Sometimes our techs help provide imaging for vascular cases in the OR performed by non-radiologists. Can we report the supervision and interpretation codes? Should we use fluoro codes 76000 and 76001, even for angioplasty guidance?


Connecticut Subscriber

Answer: Assuming you're billing for the hospital, if the operating room (OR) isn't reporting the technical side of the imaging services, you may do so. Just make certain that OR personnel are not capturing charges for these services so that you don't "double-charge" the patient.

If the procedure has a specific imaging (radiological supervision and interpretation or S&I) code, you should report the code most appropriate to the procedure performed. Example: Report 75978 (Transluminal balloon angioplasty, venous [e.g., subclavian stenosis], radiological supervision and interpretation) for the imaging services associated with venous angioplasty.

If there isn't a specific S&I code for the imaging service, use caution. The Correct Coding Initiative (CCI) edits bundle fluoroscopy (76000-76001) into many surgical procedures. For example, CCI includes 76000 in 27244 (Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage).

Also, remember that CPT designates 76000 as a "separate procedure," which means that it is usually a component of another service, and you should not report it unless it is unrelated to other procedures performed during the same session. Because of this designation, you may find that charging for 76000 results in an exception (error message) when the account goes through your facility's claims scrubber software.

The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.