Question Nephrostogram by Xray Tech?

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toria11

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How would you bill a nephrostogram being performed by an Xray tech? Per the lead tech, "The patient already has a nephrostomy tube in place before they come in to us. We don't place them here at this facility. So we inject contrast into the nephrostomy tube they already have and then take some xrays." Would this be billed with 50431 or 74425? I'm thinking the latter, since it's not a physician performing the procedure, but please let me know your thoughts.

Thanks!
 
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I am wondering the same. I bill for the radiologists only, we have 50433 performed 12/18 and 74425 performed 12/26 and keep getting the 74425 rejected
 
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SienTC1720 said:
I am wondering the same. I bill for the radiologists only, we have 50433 performed 12/18 and 74425 performed 12/26 and keep getting the 74425 rejected
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And yes! They're asking because they said 74425 is no longer being paid and they were wanting to switch to billing 50430/50431 and I'm not sure that's correct if an Xray tech is injecting contrast to take the Xrays.
 
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Your billing for the doctor, who is interpretating the films. 74425 has been deleted from the nephrostogram, so you code 50431 for the procedure. And don't worry about the tech doing the procedure. I have done nephrostograms with the doctor in the room watching over me.
Jim Pawloski, R.T. (CV), CIRCC
 
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Jim Pawloski said:
Your billing for the doctor, who is interpretating the films. 74425 has been deleted from the nephrostogram, so you code 50431 for the procedure. And don't worry about the tech doing the procedure. I have done nephrostograms with the doctor in the room watching over me.
Jim Pawloski, R.T. (CV), CIRCC
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Hi Jim! Thanks for the reply. They were billing 74425 on its own in the past and now it's not getting paid. I'm not sure why this is. I understand that it's now bundled with 50431/50432 but they weren't billing those codes. The Xray department also just told me that they don't document much detail for these other than the name of the procedure that's being performed. Kind of at a loss here. I always thought more documentation would be needed for 50431 vs. 74425.
 
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They changed the codes a few years ago and bundled 74425 into the codes. It is still billable on one code. That is injecting of a urethral catheter via ileal conduit.
 
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