bluej00526
New
Hello - I'm looking for CPT guidance on a combo report for a radiology practice.
The doctor calls the procedure "CTA chest/abdomen/pelvis/cardiac TAVI" and it's being done preop.
Technique states scans obtained of chest abdomen and pelvis from lung apices through lesser trochanters with IV contrast, with 2D & 3D prostprocessing reformatted images at independent workstation.
Findings include median sternotomy, AICD, mediastinal lipoma, main pulmonary artery dilation, prosthetic aortic valve, left effusion, cholelithiasis, cirrhosis, unspecified kidney lesion, subpleural pulmonary node, narrowing of mesenteric artery, atheromatous plaque celiac artery, and detailed aorta, iliac and infrarenal measurements.
I have researched similar claims from the previous billing company - some were billed as 74174 + 71275 + 75574; and some just 74174 + 75574.
On Medicare's LCD page (medicare.fcso.com/lcd/active/l33282) I found this: Billing 71275 plus one of the following (75571-75574) would attest to the fact that two completely separate procedures were performed in their entirety.
However I've checked on some where all 3 were billed and Medicare did pay but added a 51 mod (discount mult procedures)
I'd appreciate any thoughts. Thank you in advance
The doctor calls the procedure "CTA chest/abdomen/pelvis/cardiac TAVI" and it's being done preop.
Technique states scans obtained of chest abdomen and pelvis from lung apices through lesser trochanters with IV contrast, with 2D & 3D prostprocessing reformatted images at independent workstation.
Findings include median sternotomy, AICD, mediastinal lipoma, main pulmonary artery dilation, prosthetic aortic valve, left effusion, cholelithiasis, cirrhosis, unspecified kidney lesion, subpleural pulmonary node, narrowing of mesenteric artery, atheromatous plaque celiac artery, and detailed aorta, iliac and infrarenal measurements.
I have researched similar claims from the previous billing company - some were billed as 74174 + 71275 + 75574; and some just 74174 + 75574.
On Medicare's LCD page (medicare.fcso.com/lcd/active/l33282) I found this: Billing 71275 plus one of the following (75571-75574) would attest to the fact that two completely separate procedures were performed in their entirety.
However I've checked on some where all 3 were billed and Medicare did pay but added a 51 mod (discount mult procedures)
I'd appreciate any thoughts. Thank you in advance