Advanced Search

Radiology Coding Alert

READER QUESTIONS:

Defogram Code Preferences Vary

Published on Sat May 09, 2009

Question: I'm currently using an unlisted code for a defogram. Is this correct? Wisconsin Subscriber Answer: According to AMA's CPT Assistant (May 2003), the correct code for a defogram (also known as a defecating proctogram or defecogram) is 74270 (Radiologic examination, colon; contrast [e.g., barium] enema, with or without KUB). Note that this is the updated 2009 74270 descriptor. Caution: Some coders report that their individual payers have different preferences. For example, one practice's local Medicare requires an unlisted code, such as 76499 (Unlisted diagnostic radiographic procedure).But the local Medicaid administrator requires 74270 with modifier 52 (Reduced services). Bottom line: Use 74270 unless the payer has published instructions to the contrary.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Radiology Coding Alert

View All