Coding Challenge / radiology

How to Code for Screening Mammogram When Radiologist Finds Problem?

Watch out: Results don’t turn screening into diagnostic Question: A patient presented for a screening mammogram, and the radiologist determined the patient needed an ultrasound for a closer look. The patient returned for that test at a later date. Should I code the original mammogram as 77056 instead of 77057 because the radiologist found a possible [...] Related articles:

  1. Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s OrderKeep these additional test rules at your fingertips if your...
  2. Diagnostic Radiology ICD-9 Code Update: New Mammo Code 793.82 New code 793.82 shakes up the whole 793.x range...
  3. Radiology Coding Tips: Mammograms, CTs, MRIs and MoreRadiology coding is multi-faceted. Here are some foolproof radiology coding...

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December 5, 2009
Coding Challenge / modifier 59

Cardiology Coding Question: Separate Reporting for 37204

Question: Should I separately report right and left bronchial artery embolization? Answer: You should report 37204 (Transcatheter occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method, non-central nervous system, non-head or neck) twice for right and left lung embolization at the same encounter. In addition, if the cardiologist [...] Related articles:

  1. Cardiology Coding Education: Pacemaker Lead Check Question: The cardiologist documented testing pacemaker leads using fluoroscopy...
  2. 2 New 2010 CPT Codes for High-Tech Cardiology ServicesSteer clear of Cat. I codes for intravascular spectroscopy — here’s...
  3. OB or Not OB: That’s the Ultrasound Coding QuestionQuestion: For an ultrasound, the radiologist documented measurements of the uterus,...

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November 7, 2009
RAC / radiology / Toolkit

Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s Order

Keep these additional test rules at your fingertips if your want to keep auditors out of your hair. The Office of Inspector General and Recovery Audit Contractors are out to audit non-compliant ultrasound claims, so knowing the rules is more important than ever. And we’ve got a link and a handy checklist to keep you out [...] Related articles:

  1. OIG Slaps Radiology Practice With Record $2 Million PenaltyThink it’s okay to provide diagnostic tests without physician orders?...
  2. Documentation Checklist for Complex Radiology Treatment Planning (77263) Think you know all you need to know about...
  3. 3 Big Fee Schedule Changes for Radiology Coding & BillingCapture additional $2,305 for Bilateral 50593 by Applying Fee Schedule...

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October 21, 2009
Audit / Cardiology / Oig / Provider News

OIG Auditors to Cardiologist: You’re Billing Medicare Properly

Report reveals what he and his billing staff did right. Does your practice have the right stuff? Turns out the old saying is true: If you haven’t done anything wrong, an OIG audit is nothing to worry about. A New York cardiologist who collected over $1.3 million over a three-year period for 5,061 claims caught the OIG’s [...] Related articles:

  1. Double Ultrasound Codes Spell Double Trouble With AuditorsAuthorities scrutinize medical necessity for 76830 & 76856. The OIG...
  2. Medicare Fraud Fighter Reveals 9 Billing Patterns That Draw HEATA Department of Justice senior trial attorney behind the widely...
  3. HHS Plans to Crack Down on Fraud, Improper BillingMedicare loses $60 billion a year in improper payments. A...

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October 20, 2009