Neurology & Pain Management Coding Alert

Question: Our clinic purchased a mini c-arm, and it is the only x-ray unit in the building. If we-re using the device for standard views and not stress or motion views, should we report the CPT codes for the multiple views of whatever area we are x-raying, or should we report the fluoroscopy views?

Georgia Subscriber Answer: If you are storing the images on film or in a PACS system permanently, you can report the regular x-ray exam codes (for example, 72220, Radiologic examination, sacrum and coccyx, minimum of two views). The x-ray codes require that you store permanent images.

If you use the c-arm to view the anatomy without taking permanent images, you should instead report 76000 (Fluoroscopy [separate procedure], up to 1 hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]), assuming you aren't just taking a -quick look- but are instead using the c-arm for a medically necessary reason to evaluate joint motion or structure. Clinical and coding expertise for You Be the Coder and Reader Questions  provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, CodeRyte Inc. coding analyst and coding review teacher.