Wiki ultrasound of abdomen with pelvis

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prem_ponnuru

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Hi all,

I am coding for radiology physicians. I am facing lot of problems when coding ultrasound abdomen with pelvis (74150 and 72192). Medicaid is rejecting 72192 alongwith 74150 at same time with same document.
can we code 74150 and 72192 both at same time in one document if he reads all pelvic organs also? please kindly give me the information

thanks a lot

prem.
 
ok...I'm confused - 74150 is a CT of the abdomen - and 72192 is a CT of pelvis - neither are "ultrasounds". An ultra sound of the abdomen is in the 76700 - 76776 area, and ultrasounds of the pelvis is 76830 - 76857 (non-obstetrical) area...
so are they really doing CT's or unltrasounds?
maybe the dx's you're using aren't a covered dx? Have you checks the LCD lists?
in any case, I don't see an issue using both the codes per the NCCI edits.
 
The codes you mentioned are CT (computerized Tomography) codes. Either way you should check the local Medicaid Fee Schedules to see what their requirements are, they might need a modifier sometimes. Most often the Medicaid does not follow the NCCI. A copy of the radiology report with the appeal gets these procedures paid. They just need the radiology reports to see that both procedures were done.
 
Hi Donna/Meenal,

Thanks for your response.

It was a mistake not ultrasound it is CT.
My problem is in "one document" our provider reading both abdomen and pelvis organs including prostate and bladder. so I considered both were to be done and gave 74150 and 72192 but medicaid denied 72192 stating that only ct abdomen was done and while doing ct abdomen he could read pelvis organs also.

So, if the doctor reads pelvis organs in ct abdomen can we add 72192 with only one document or do we need a separate document and is it necessary for both the studies to be done in separate timings or sessions.

I am very new to this aapc forum please help me.

I really appreciate your support.

Prem.
 
We can bill both!

Dear Prem,

I am also billing both 74150 and 72192 for CT abdomen and CT Pelvis for my providers. We are not facing any issues for both the procedures. And more over there is no effective CCI-Edits for these services. You just check your LCD and try to appeal with the medical reports.

Hope this may help you!

Thanks,
B.T.RamKumar, CPC.
 
Hi Ram kumar,

Actually ordering procedure is only ct abdomen not both but doctor reading pelvis organs also and we have only one documentation. So in this scenario can we consider that ct pelvis is also to be done and add 72192 or only ct abdomen.

Ram kumar May I know u r from which place?

Regards,

prem.
 
No.

Dear Prem,

That's fine Prem. Just check your insurance policies to which insurance you are billing. I would suggest you, if you feel that a single document covers CT abd and CT pelvis, then you need to confirm with your provider that he/she is doing both the services or only one. It will help you to add 72192 along with 74150. May be your provider doesn't know about this. This will help your provider and as well as you or your corporate.

And I am from chennai, India.

Hope this helps you lot!

Thanks,
B.T.RamKumar, MBA, CPC.
 
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