Wiki 3d Imaging For Facial Paralysis

[tpgloc]

I am coding for a Facial Plastics physician and she has a question. She would like to see if we could charge for the short video analysis she does on her facial nerve/facial paralysis patients. She uses these to assess their progress - pre and post physical therapy and perhaps pre and post surgery or other forms of treatment. The other charge she would like to explore is the external photographs she uses to track/document medical progress. She was looking at 92516 or 96000 but I do not like either of those codes. Do you know of any code that would help me out? Thanks for any info you can send me. Geraldine O'Connell, CPC

 

[FTessaBartels]

Just E/M

I would charge the E/M as supported by documentation.

92516 lay description states in part: These tests include an ENoG or an electromyogram that measure nerve conduction to diagnose degenerative disorders. So I don't think videography or photography is sufficient.

96000 lay description states in part: To conduct a biomedical analysis, patient movements are recorded, digitized, copied on computer, and processed. For example, when calculating net joint moments, the joint center is calculated using a local coordinate system created from body markers. When tracking markers in 3D using video, two or more cameras are used to identify the markers. After all parameters are found (e.g., linear acceleration, angular acceleration, ground reaction forces) and gathered using stereo X-rays or MRI Again, I don't think your scenario meets the guidelines.

If the physician herself is performing the video analysis and/or photography she might want to document "prolonged service" (99354 in the office). She would document in addition to her standard E/M documentation something along the lines of "An additional 35 minutes was spent in direct face-to-face care with the patient performing video analysis of facial paralysis."
The prolonged service codes can be used even with the lowest level of E/M service, as long as it is clearly separately documented as such. But it has to be at least 30 minutes of direct face-to-face time in addition to the E/M service to report it.

Good question! Let us know how it turns out.

F Tessa Bartels, CPC, CPC-E/M