Wiki CT Abd/Pelvis

[ksamsblair]

I would greatly appreciate assistance in coding the following scenario:

Patient presents to the ER and has a CT pelvis without contrast (72192) at 2:44 p.m. The radiologist interprets the study and recommends a follow-up CT pelvis be performed with oral and IV contrast. The pateint is subsequently admitted as an inpatient and at 11:49 p.m. has a CT abdomen/pelvis with IV contrast (74177) that is interpreted by a different radiologist.

Should these codes be combined to 74178 or should you use 74177 and 72192 with a 59 modifer.

Your help is greatly appreciated.

 

[aaron.lucas]

First of all, who are you billing for, the hospital? If so, are the radiologists in question actually employed by the hospital or are they outsourced? You should be able to bill the combo, plus the abdomen CT with a -59 because they were done at different times and read by different radiologists. If the radiologists both work directly for the hospital then you can bill globally. If they are outsourced, then you should use -TC for the hospital and the radiology company that rents out their people would bill with -26. Hope this helps, does it make sense?