Part B Insider (Multispecialty) Coding Alert

Published on Thu Oct 19, 2006 PDF

April brings a lot more than showers this year--next month will also shower radiologists with a host of new Correct Coding Initiative edits.

You won't be able to use a modifier to override edits bundling cardiac blood pool imaging codes 78472-78473, 78481-78483 and 78496 with myocardial perfusion imaging codes 78460-78465.

And you can't use a modifier to override edits that make multiple myocardial perfusion imaging studies code 78461 a component of multiple cardiac blood pool imaging studies codes 78473 and 78483.

You would never perform myocardial perfusion imaging studies on the same date as cardiac blood pool imaging studies in any case, says Jeff Fulkerson, senior certified coder in the radiology department at Emory Health Care in Stockbridge, GA. If you're already injecting a radionucleide into the cardiac tissue to see how it perfuses through the tissue, it doesn't make sense to inject a second radionucleide into the blood. You wouldn't be able to see anything, he explains.

Subtraction studies code 76350 becomes a component of 151 other radiology codes, and you can't use a modifier on any of those edits. Say goodbye to billing CT needle placement with CT codes 70450-70559, 71250-71555, 72125-72158, 72191-72198, 73200-73223, 73700-73725, 74150-74185.

You can also forget about billing 76350 with cardiac MRI codes 75552-75555, aortography codes 75600-75790 or venography codes 75801-75891. These edits make sense, because you shouldn't be billing 76350 any longer, says consultant Donna Richmond with CodeRyte in Bethesda, MD.

You also won't be able to use a modifier to override an edit bundling 76355 (Computed tomography guidance for stereotactic localization) with 61770 (Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source).

Meanwhile, CT scan codes 71250-71275 all become components of new CT angiography codes 0144T-0150T, but you can override those edits with a modifier. "You're not supposed to be doing a CT of the chest as well as a CTA of the chest," explains Fulkerson. "Those should be few and far between."

TEE, Ultrasound Bundled With Cardiac Catheterization

Cardiac catheterization codes 93508-93533 and 93541-93556 all become components of every code in Intracardiac Electrophysiological Procedures/Studies section (93600-93662), except for add-on codes and evaluation code 93660. 

Transesophageal echocardiography (TEE) code 93318 also becomes a component of 93600-93662, except for add-on codes. And 93318 becomes a component of all cardiovascular surgery codes from 33200 to 33261. 

Ultrasonic guidance codes 76942 and 76956 also become components of those same codes: 93600-93662 (except add-ons) and 33200-33261. Each of the above edits can be overridden with a modifier.