CT brain without then with contrast - HELP

Dfreddie

Networker
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31
Location
Beach, North Dakota
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I need some help to clarify this situation. Radiology is telling me that they are billing both 70450 and 70460 because they were performed a little over an hour apart. Reason for the first scan was left-sided facial weakness, reason for the next w/contrast was possible dural mass.

In my research, this would not be appropriate and no modifier is applicable - the correct code on the same DOS would be 70470.

Am I right? Or am I missing something?
 
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3
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You are correct! Per the NCCI edits billing both is not appropriate and these will be denied. These should be bundled together into code 70470.

4297
 
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149
Location
Clovis, CA
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So what happened... someone looked at the imaging without contrast and said, hey, I think we need some clarity here, do it again with contrast? Or did something else happen?
 

luhre

Networker
Messages
60
Location
Syracuse, NY
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When a CT scan without contrast is reported on the same day as a CT scan with contrast, on the same anatomical site, use the code for "without contrast followed by with contrast". You are right, 70470 would be correct.
 
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