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2017 NEW RADIOLOGY CODES

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Changes to CPT codes take place every year, new codes are added, some are revised and some are deleted. 2017 is no different. Because there has to be a match between your documentation and the code(s) assigned, it is imperative to review the new codes along with the code descriptions. The purpose of this newsletter is to point out what’s new along with the 2017 professional Ohio Medicare allowable for a facility setting (hospital). Take a moment to review each of the codes and consider how these new codes could possibly impact your practice.

DIAGNOSTIC RADIOLOGY: 

Four new codes were added to diagnostic radiology.  CPT 76706 Ultrasound screening study for AAA was added to replace the current HCPCS code G0389 (CY 2016 Ohio Medicare allowable $29.09), and new mammography codes were added to include CAD.

CPT CODE

FACILITY

DESCRIPTION

76706-26

$27.73

Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)

*77065-26

**

Diagnostic mammography, including computer-aided detection (CAD) when performed, unilateral

*77066-26

**

Diagnostic mammography, including computer-aided detection (CAD) when performed, bilateral

*77067-26

**

Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed

*Screening mammogram G0202-26 ($36.95), bilateral diagnostic mammogram G0204-26 ($48.58), and unilateral diagnostic mammogram G0206-26 ($39.10) are not new codes but the code descriptions have been revised to include CAD when performed

** Not priced by Medicare

 

MODERATE (CONSCIOUS) SEDATION:  

Effective January 1, 2017 moderate sedation will no longer be bundled into the interventional procedure and can be separately reported.  Documentation requirements include the use of an independent trained observer to assist with the monitoring of the patient and the intraservice time in minutes.  The intraservice time begins with the administration of the sedation agent(s) and ends with personal continuous face-to-face time with the patient by the provider.

CPT CODE

FACILITY

DESCRIPTION

99151

$23.69

Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age

99152

$12.32

initial 15 minutes of intraservice time, patient age 5 years or older

99153

$10.24

each additional 15 minutes intraservice time

 

 

INTERVENTIONAL RADIOLOGY: 

Numerous changes took place this year for interventional radiology procedures.  In addition to the new codes and new descriptions there are guidelines that have to be followed.  CPT provides guidelines at the beginning of each section in the CPT book and CMS has the National Correct Coding Initiative (NCCI) Policy Manual. Review the procedures you perform.  Take note of the details you need to incorporate in your documentation.  If you would like more information regarding the documentation specifics, contact us.

 

AV DIALYSIS PROCEDURES

New bundled codes were created.  Angioplasty, stent placement, thrombectomy, and embolization are now reported with specific dialysis circuit codes. Peripheral zones and central zones were changed to peripheral segments and central segments.

CPT CODE

FACILITY

DESCRIPTION

36901

$148.37

Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report;

36902

$221.08

with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

36903

$302.68

with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

36904

$348.54

Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s);

36905

$437.49

with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

36906

$510.57

with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit

‘+36907

$127.42

Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty

‘+36908

$191.02

Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment

36909

$181.27

Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention

 

ANGIOPLASTY 

New codes for angioplasty will bundle the radiological supervision and interpretation into the surgical portion of the procedure.  The new codes include all of the work and imaging required to complete the angioplasty.  Non-selective and/or selective catheterizations are still separately reported.  If a lesion extends across the margins of one vessel into another, but can be treated with a single therapy, the intervention should be reported only once.   It is also important to note, CPT provides clear instructions – “When additional, separate and distinct ipsilateral or contralateral vessels are treated in the same session, 37247 and/or 37249 may be reported as appropriate,” in other words, 37246 or 37248 cannot be bilaterally coded.

CPT CODE

FACILITY

DESCRIPTION

37246

$363.10

Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery

‘+37247

$180.07

each additional artery

37248

$312.22

Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein

‘+37249

$153.21

each additional vein

 

MECHANOCHEMICAL (MOCA) VEIN ABLATION 

Two new codes were developed to report mechanochemical ablation that uses dual treatments mechanical plus chemical to ablate the vein.  These codes include any anesthetic, all catheterizations of the treated veins, all ultrasound and/or other imaging for the entire procedure, the therapy delivered and closure of the puncture site.  The supplies and equipment used for these services are included when performed in an office setting.

CPT CODE

FACILITY

DESCRIPTION

36473

$176.99

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated

‘+36474

$88.66

subsequent vein(s) treated in a single extremity, each through separate access sites

 

EPIDURAL INJECTIONS

The current codes 62310-62319 will be deleted.  New codes have been added to make the distinction between the use of imaging vs. non-imaging.

CPT CODE

FACILITY

DESCRIPTION

62320

$102.80

Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic, without imaging guidance

62321

$110.87

with imaging guidance (ie, fluoroscopy or CT)

62322

$88.44

Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance

62323

$101.09

with imaging guidance (ie, fluoroscopy or CT)

62324

$94.55

Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic ; without imaging guidance

62325

$108.86

with imaging guidance (ie, fluoroscopy or CT)

62326

$92.50

Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance

62327

$98.51

with imaging guidance (ie, fluoroscopy or CT)

 

SUMMARY: 

  • As expected, major changes in CPT will take place January 1, 2017.  Understanding what to include in your documentation is crucial for appropriate code assignments which is critical for financial and compliance success.  Take the time to review CPT changes every year.
  • It is also important to mirror CPT language.  Most auditors and payers are looking for an exact match between your documentation and the code assignment(s).  Also, include the specifics required as identified in the code description.  For example, if the code is selected by the artery treated, name each artery.
  • Remember, even though the focus of this newsletter is on the new CPT codes, documenting medical necessity is one of the main reasons that drives a payer to make a decision  whether to pay.

  • We are here to help you succeed.  If you have any questions regarding the new codes including additional information in either the coding guidelines or even the NCCI Policy Manual  please contact us.

     
    If you have a documentation issue that you would like to see covered, please contact Wendy Block, CPC, RCC, and CIRCC at wblock@streamlinemd.com or by phone at 330.564.2618

 

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