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Radiology Coding Alert

READER QUESTIONS:

Proceed Slowly With Separate Procedures

Published on Tue Aug 23, 2005

Question: I noticed a number of codes in the radiology section that have the phrase "separate procedure" in the descriptors. What are the rules for codes with this phrase?


Texas Subscriber
Answer: In short, when your CPT manual designates a code as a "separate procedure," you may code it separately only if the procedure is independent of other services provided at the same time.

What to do: You may report the "separate procedure" code by itself. If the physician performs the separate procedure during the same encounter with other procedures but it is separate and distinct from them, you may report it along with other codes, but you'll usually need to append modifier 59 (Distinct procedural service) to the "separate procedure" code.

"Separate procedure" radiology codes include:
  76000 - Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (e.g., cardiac fluoroscopy)
  78110-78111 - Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure) ...
  78120-78121 - Red cell volume determination (separate procedure) ....
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