Wiki Radiology/Fluoroscopy

[binateans]

I have a claim billed with cpt code 29075 for a repair on a cast in addition to cpt code 76000,fluoroscopy. Originally these two codes came up as unbundled. Provider then added a 59 modifier to 76000 and when the notes came over provider stated that "x-rays were obtained and three panoramic views were taken of the radius and ulnar fracture."

My question is whether 76000-59 can be billed with 29075 when it is directly related to that casting. 76000 comes up as a (separate procedure) in the CPT manual and it states that these (separate procedures) should not be coded in addition to the basic procedure code of which it is considered an integral component.

Is there a more appropriate code to report the "3 panoramic views" that were obtained other than 76000-59 to make it payable.

I don't feel 59 makes this a distinct procedural service and now I am questioning whether this was the appropriate radiological code to report in the first place.

Any feedback will be greatly appreciated.

Thank you in advance

Tina Moschetta

 

[LTibbetts]

For radiology it is better to go with the -TC or -26 modifiers depending on who owns the equipment. Check out the radiology guidelines in your CPT book in the beginning of that chapter. It talks about "seperate procedure" coding rules as well.

Modifier -59 is only to be used for a "Seperate Distinct Procedure", which means that it is used only for a procedure or service that is distinct or independant from other non-E/M services performed on the same date of service. It is used for procedures that are not normally performed together. Hope this helps a little bit. If not, look into the Modifiers forum about issues with the -59 modifier. There are many posts discussing it