WRITTEN INTERPRETATION AND REPORT DOCUMENTATION
Based on the increased number of provider questions regarding written interpretation and report of diagnostic X-rays, Medicare expects the separate and distinct report (may be on separate paper or...
View ArticleRadiology ADDED CPT code 74176, 74177, 74178
Radiology – 5 New Codes– CT Angioplasty Abdomen/Pelvis• Without Contrast – 74176• With Contrast – 74177• Without Contrast 1+ Body Regions – 74178– Ultrasound Extremity Non-Vascular• Complete - 76881•...
View ArticleRadiology CPT code list
Diagnostic Radiology (Diagnostic Imaging) CPT 70010-76499Aorta and Arteries CPT 75600-75790Diagnostic Ultrasound CPT 76506-76999Radiation Oncology CPT 77261-77799Clinical Treatment Planning CPT...
View ArticleRadiology Billing Basic
Radiology• Under constant review due to technological advancement• Four subsections Diagnostic Radiology70010* - 76499includes computerized tomography (CT),magnetic resonance imaging (MRI),...
View ArticleRadiologist, diagnositic test, treating physician,treating practitioner...
DefinitionsA radiologist performing a therapeutic interventional procedure is considered a treating physician. A radiologist performing a diagnostic interventional or diagnostic procedure is not...
View ArticleNew Fees for Procedure Code 75946
Current Procedural Terminology (CPT) defines 75946 as: “Intravascular ultrasound (non-coronary vessel), radiological supervision and interpretation; each additional non-coronary vessel (list separately...
View ArticleEKG code 93010 denied as Duplicate - what should we do
Chest X-ray or EKG: Duplicate DenialsDenial Reason, Reason/Remark Code(s)• M-80, CO-18 - Duplicate Service(s): Same service submitted for the same patient, same date of service by same doctor will...
View ArticleTransportation Component (HCPCS Codes R0070 - R0076) and modifiers
This component represents the transportation of the equipment to the patient. Establish local RVUs for the transportation R codes based on carrier knowledge of the nature of the service furnished....
View ArticleDiagnostic Cardiology Services: Medical Necessity Denials co 50, 57
Denial Reason, Reason/Remark Code(s)• CO-50, CO-57, CO-151, N-115 - Medical Necessity: An ICD-9 code(s) was submitted that is not covered under a LCD/NCD• CPT codes: 93307, 93320,...
View ArticleWhy My Claim May Be Selected for Medical Review
As part of Palmetto GBA’s role as the Railroad Medicare Specialty Administrative Contractor (RRB-SMAC), we are charged with examining the reasonableness and medical necessity of the services being...
View ArticleQ0, Q1 MODIFIER USAGE ON FDG PET oncologic claims
Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors (ThisChange Request (CR) rescinds and fully replaces MM 846This article is based on Change Request (CR) 8739, which advises...
View ArticleRadiology billing technical component and professional component basics...
Billing for Radiology Services A physician or other supplier may bill and receive Part B payment for the technicalcomponent (TC) or professional component (PC) of diagnostic tests which the physicianor...
View ArticleRADIOLOGY CPT CODES - Addition, Revised and Deleted Codes for 2015
Revised Codes77401Radiation treatment delivery, superficial and/or ortho voltage, per day77402Radiation treatment delivery, >1MeV; simple77407; intermediate77412; complexNew Codes76641Ultrasound,...
View ArticleNuclear Medicine (CPT 78000 - 79999)
Payments for RadionuclidesThe TC RVUs for nuclear medicine procedures (CPT codes 78XXX for diagnosticnuclear medicine, and codes 79XXX for therapeutic nuclear medicine) do not include the radionuclide...
View ArticlePositron Emission Tomography (PET) Scans – General
InformationPositron emission tomography (PET) is a noninvasive imaging procedure that assesses perfusion and the level of metabolic activity in various organ systems of the human body.A positron camera...
View ArticleHCPCS Code for PET Scan for Myocardial Viability CPT code 78459
78459 - Myocardial imaging, positron emission tomography (PET), metabolic evaluationCoverage of PET Scans for PET Scan for Thyroid Cancer.For services furnished on or after October 1, 2003, Medicare...
View ArticlePlace of Service (POS) Instructions for the Professional Component (PC or...
Many of the diagnostic services, including radiology services, provided by physicians/practitioners contain both a technical component (TC) and a professional component (PC). Often, the PC and TC of...
View ArticleX-rays and EKGs Furnished to Emergency Room Patients
The professional component of a diagnostic procedure furnished to a beneficiary in a hospital includes an interpretation and written report for inclusion in the beneficiary’s medical record maintained...
View ArticleServices Bundled Into Treatment Management Codes
Carriers do not make separate payment for services rendered by the radiation oncologists or in conjunction with radiation therapy.11920 Tattooing, intradermal introduction of insoluble opaque pigments...
View ArticleMedicare Basics
Medicare was established in 1965 and is currently the world's largest insurance program.The Centers for Medicare & Medicaid Services (CMS) administers Medicare, Medicaid and the State Children's...
View Article