Radiology Coding Guidelines 2023

As expected the official implementation of new and amended codes has come into effect from January 1, 2023. The availability of the 2023 CPT® code files should alert radiology professionals and other interested parties to the extent of the upcoming changes. Staff and coders may get ready for a great year while ensuring compliance by being aware of the changes.

Let’s look into the edits and inclusion guidelines for the existing and new codes.

Non-interventional Diagnostic Imaging

Non-invasive/interventional diagnostic imaging includes (but is not limited to) standard radio graphs, single or multiple views, contrast studies, computed/computerized tomography, and magnetic resonance imaging. The “CPT Manual” allows for various combinations of codes to address the number and type of radio graphic views.

  • Only one unit of service for appropriate code will be reported if imaging studies are performed repeatedly during the course of a radio logical encounter due to factors like substandard procedures or additional view needs.
  • CPT code 76380 (Computed tomography, limited or localized follow-up study) shall not be reported with other computed tomography (CT), computed tomography angiography (CTA), or computed tomography guidance codes for the same patient encounter.
  • CPT code 77075 (Radiologic examination, osseous survey; complete (axial and appendicular skeleton)) includes radio-logic examination of all bones. CPT codes for radio-logic examination of other bones shall not be reported in addition to CPT code 77075.
  • CPT code 77073 (Bone length studies…) includes radio-logic examination of the lower extremities. CPT codes for radiologic examination of lower extremity structures shall not be reported in addition to CPT code 77073 for examination of the radio-logic films for the bone length studies.
  • CPT code 75635 describes computed tomographic angiography of the abdominal aorta and bilateral iliofemoral lower extremity runoff. CPT codes 73706 and 74175 shall not be reported with CPT code 75635 for the same patient encounter. CPT code 73706 plus CPT code 74175 shall not be reported in lieu of CPT code 75635.
  • CPT code 77063 is an Add-on Code (AOC) describing screening digital tomosynthesis for mammography.
  • CPT codes 72081-72084 describe radio-logic examination of the entire spine, the codes differing based on the number of views. The other codes in the CPT code range 72020- 72120 describe radio logic examination of specific regions of the spine differing based on the region of the spine and the number of views.

Interventional/Invasive Diagnostic Imaging

  • Fluoroscopy reported as CPT code 76000 is integral to many procedures including, but not limited, to most spinal, endoscopic, and injection procedures and shall not be reported separately.
  • Computed tomography of the heart (CPT codes 75571-75573) and computed tomographic angiography of the heart (CPT code 75574) include electrocardiographic monitoring if performed.
  • CPT codes 22510-22512 represent a family of codes describing percutaneous vertebroplasty.
  • CPT codes 22513-22515 represent a family of codes describing percutaneous vertebral augmentation 76376 and 76377 represents three-dimensional (3D) rendering of an imaging modality (e.g., CPT codes 76376, 76377)

Nuclear Medicine:

  • Myocardial perfusion imaging (CPT codes 78451-78454) is not reportable with cardiac blood pool imaging by gated equilibrium (CPT codes 78472-78473)
  • HCPCS codes A9500, A9540, and A9541 describe radio pharmaceuticals labeled with Technetium Tc-99m that may be used for separate nuclear medicine studies on the same date of service as a nuclear medicine study using the radio pharmaceutical described by HCPCS code A9512.
  • Tumor imaging by positron emission tomography (PET) may be reported with CPT codes 78811-78816. If a concurrent computed tomography (CT) scan is performed for attenuation correction and anatomical localization, CPT codes 78814-78816 shall be reported.
  • The procedure described by CPT code 77778 (Interstitial radiation source application, complex…when performed) requires that a radiation source be applied interstitially.
  • If the radiation source application occurs post operatively in a different room, the radiation oncologist may report CPT codes 77770-77772 (Remote afterloading high dose rate radionuclide brachytherapy…) for the radiation source application.
  • Any abdominal radiology procedure that has a radiological supervision and interpretation code (e.g., CPT code 75625 for abdominal aortogram) includes abdominal x-rays (e.g., CPT codes 74018-74022) as part of the total service.

All medical coders must stay well informed with the coding changes in order to receive appropriate compensation from payers. They must also ensure that all members, including medical billers and documentation experts, are knowledgeable about these changes.

Source: https://www.cms.gov/files/document/chapter9cptcodes70000-79999final11.pdf

At QWay Healthcare, we keep track of all modifications to the ICD -10 and CPT codes used in medical coding, particularly as new and updated codes are released yearly. To get hassle free experience in your revenue cycle management you can reach to QWay Healthcare professionals who can help you with doubling your revenues with proper documentations and error free coding. You can make sure that all of your procedures are accurately coded in this manner.

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