You Be the Coder:
Fluoroscopy
Published on Mon May 01, 2000
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: What are the correct codes to use when fluoroscopy is used to inject MRI contrast into a shoulder joint and a non-ionic contrast is also injected for needle placement with films? We are debating among CPT Codes 73040 (radiologic examination, shoulder, arthrography, radiological supervision and interpretation), 76000 (fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) and 73030 (complete, shoulder, minimum of two views)?
Roger Smith
Clifton Springs Radiology, Clifton Springs, N.Y.
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Answer: If you are performing a magnetic resonance arthrogram, there is a specific way to code for this. According to a 1998 American College of Radiology Bulletin article, the coding should be as follows:
Code for the appropriate injection code for the injection of contrast into the joint. For the shoulder, this would be 23350 (injection procedure for shoulder arthrography).
In most cases, the joint injection is performed under fluoroscopic guidance, so 76000 would be added.
Next, you should code for the MRI itself73221 (magnetic resonance [e.g., proton] imaging, any joint of upper extremity).
If a full and complete conventional arthrogram is performed (plain films) in addition to the MRI, then you may also charge the supervision and interpretation code for this procedure73040. If this is the case, you cannot charge for the fluoroscopy because fluoroscopy is inherent in the radiology supervision and interpretation codes.
Source for You Be The Coder is Stacey Hall, RHIT, CPC, CCS-P, director of corporate coding for Medical Management Professionals in Chattanooga, Tenn.
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