For this weeks blog post, I thought I’d have you guys ask me questions. What questions do YOU have about diagnostic radiology coding? It can be about CPT, ICD-10, guidelines etc. Is there anything you’d want me to answer? Please post in the comments below or send me an email at firstname.lastname@example.org.
I’ll post the questions and the answer in the blog post for next week.
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5 thoughts on “Diagnostic Radiology Coding Questions?”
If you are coding an US/Kidney and there is documentation for the left and right kidney, but the report states the bladder was not visualized, would you code this as 76775 for limited?
Well, this might depend on client guidelines. There might be a certain way they’d want that handled. (They might want it coded as a limited or sent back for an addendum so it could be coded as a complete if more info was put in the report). But, based on what you’re telling me…I would think it’s still a complete because they tried to see the bladder but couldn’t. But again, please doublecheck with your coding manager.
I have a question that has come up many times in the long history of our radiology practice.
How do you code a first time US done on what is thought to be a 10-12 week pregnant female for dates and viability, but after dating, you determine the fetus is 14 weeks 2days? The anatomy would be so limited dear to early dates, that a 76805 doesn’t seem feasible. A 76815 is too limited if you are doing all the measurements for fetal age. 76816 seems best, but it specifically is described as a follow up exam for problems or re dating.
Thanks for reaching out. Well, this is a tough call because of the description of the CPT codes. Code 76801 is for before 14 weeks and 76805 is for after 14 weeks and includes more anatomy of the fetus that would be hard to visualize at that age. Insurances have their own rules with OB ultrasounds, and only allow a certain number per pregnancy, so it might be best to call them and see how they would prefer it billed in that case. My first thought is that it’s either a 76801 or 76815, but again, without seeing a report or knowing the specific insurance rules, it’s tough to say. Sorry that’s not more helpful..
Yes. That is the problem we are having. By CPT description, it seems the 76805 is the “Correct” option but not the best for patient care. Since we are doing dating and minimal anatomy, we have been charging 76816 for the early 2nd trimester scans and then 76805 at 20 week scan. But maybe it would be better to charge 76815.