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Radiology Coding Alert

Reader Questions:

Payers May Label DMX 'Experimental'

Published on Sat Nov 15, 2008

Question: Which CPT code should I use for spinal digital motion x-ray?West Virginia SubscriberAnswer: You should report 76120 (Cineradiography/videoradiography, except where specifically included) for digital motion x-ray (DMX), according to the AMA's CPT Assistant (April 2004). CPT also includes an add-on code when the radiologist performs the service with another routine exam, +76125 (Cineradiography/videoradiography to complement routine examination).Note: CPT Assistant indicates 76120 is more appropriate than 76499. But you may find payer policies matching digital motion x-ray to unlisted procedure codes. For example, Mountain State Blue Cross Blue Shield's "Radiographic Imaging Techniques" policy pairs videofluoroscopy/digital motion x-ray with 76496 (Unlisted fluoroscopic procedure [e.g., diagnostic, interventional]) and 76499 (Unlisted diagnostic radiographic procedure) (www.msbcbs.com/medpolicy/X-19-006.html).Reality: Payers, including Mountain State, may consider spinal digital motion x-ray experimental and won't cover it.
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