Radiology Coding Alert

Question: Do mastoid codes 70120 and 70130 represent bilateral exams? Nevada Subscriber Answer: No. Codes 70120 (Radiologic examination,mastoids; less than three views per side) and 70130 (... complete, minimum of three views per side) are unilateral, according to the Medicare Physician Fee Schedule (MPFS). How to check: The MPFS includes a "Bilt Surg" column, which reveals the Bilateral Surgery indicator for each code. Codes 70120 and 70130 have a "3" in this column. That means "the usual payment adjustment for bilateral procedures does not apply," according to the "National Physician Fee Schedule Relative Value File Calendar Year 2010." So you should charge both sides separately at their normal fee. Most services with a "3" are radiology procedures or other diagnostic tests that surgery rules don't apply to. You can search the fee schedule online at www.cms.gov/pfslookup. Tip: Likely ICD-9 codes for these procedures include the following: 383.x -- Mastoiditis and related [...]