Wiki Which HCPCS is used for Conray 60 for Arthrogram?

[jbaird]

How would you code for the Arthrogram mixture of contrast?

"a mixture prepared using 0.1 cc Magnavist gadolinium contrast, 10 cc preservative free saline, and 10 cc Conray 60 iodinated contrast at a 1:200 dilution was administered without incident under real-time fluoroscopic observation. 15 cc total administered volume."

A4216 with 1 unit for the 10cc saline
A9579 with 1 unit for the 0.1cc Magnevist
Unsure of HCPCS for the Conray 60??

Thanks!

 

[jbaird]

This was for an arthrogram injection into the shoulder joint followed by an MRI. I agree, I thought it was unusual. I was looking at Q9958 because of the 'up to 149', but not having seen Conray in about 20 years of coding arthrograms I wanted to be sure. Do you agree with my units for A4216 and A9579? I wanted to make sure I do all of the units correctly for all 3 codes. Thank you so much!!

 

[jbaird]

I would be coding this 23350, 77002 as this is not a full arthrogram done in x-ray, but just the joint contrast injection with fluoro guidance prior to MRI/73222. It is global/office. I found the Conray 60 unusual too. Normally the intra-articular injection is done with Gadavist or Magnevist mixed with saline for MRI -OR- a LOCM/Q9967 mixed with saline if the MRI is contraindicated and they need a CT instead.