Code for ET Tube Postion

dasluna

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I have a radiology procedure (chest x-ray) that was done to check the ET Tube position. I am torn between codes. Can anyone offer any insight on which code they would use to bill this?
 
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Lizz B

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Ancillary Coder

I'm very interested in reviewing answers to this question as I run into this situation a lot. Employed as an ancillary coder in an acute care hospital. My understanding is that, if the radiologist is reviewing a film for placement, and he is not actually placing the tube himself (ie; ER phys placing endotrachial tube and NG tube, portable xr done to check placement, radiologist reads film), you cannot code with a fitting and adjustment code as the radiologist is only reading the film and not making the adjustment.

I would love to find some clear-cut documentation on this subject. If there is nothing else to code on the xr, can I use an 'Aftercare' code? Perhaps V58.89?

Thanks in advance for all opinions and suggestions.
 

cpccoder2008

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You can also use the diagnosis for which they are intubating the patient. We do chest x-ray's all the time to check for placement but the ET tube is always placed by another physician.
 

radbar08

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Remember, V58.82 is describing the reason for the encounter, not the encounter itself, so even if the radiologist didn't actually adjust the ET tube, (s)he can still use V58.82. Appending Modifier 26 to the CPT code will tell the payer that this is for the radiologist's interpretation of the x-ray, and V58.82 will tell them that the reason the patient had the x-ray was for the purpose of verifying the placement and position of the ET tube.
 
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