2019 CPT Code Update: Interventional Diagnostic Radiology

11/27/2018

2019 CPT Code Update: Interventional & Diagnostic

Radiology

Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC, AAPC Fellow President & Senior Consultant RadRx

December 5, 2018

RadRx

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Speaker Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC

? Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC, RCC is President & Senior Consultant at RadRx in Stuart, FL. Stacie is a nationally sought out speaker who provides consulting services to providers of diagnostic and interventional radiology services. She is the author of the book Cracking the IR Code: Your Comprehensive Guide to Mastering Interventional Radiology Coding and creator of Mastering Interventional Radiology & Cardiology Online Education Program. Stacie has 27 years experience in healthcare, 18 of which she has spent working in radiology. She is a nationally sought out speaker who has presented well over 200 coding seminars.

Contact Email: info@ Website:

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Revised Radiology Guidelines

? Supervision and Interpretation, Imaging Guidance

? "Many services include image guidance and imaging guidance is not separately reportable when it is included in the base service. The CPT code set typically defines in descriptors and/or guidelines when imaging guidance is included."

? "All imaging guidance codes require: (1) image documentation in the patient record and (2) description of imaging guidance in the procedure report. All RS&I codes require: (1) image documentation in the patient's permanent record and (2) a procedure report or separate imaging report that includes written documentation of interpretive findings of information contained in the images and radiologic supervision of the service." RadRx

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Revised Radiology Guidelines

? Written Report(s)

? "With regard to CPT descriptors for imaging services, "images" must contain anatomic information unique to the patient for which the imaging service is provided. "Images" refer to those acquired in either an analog (ie, film) or digital (ie, electronic) manner."

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11/27/2018

DIAGNOSTIC RADIOLOGY

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Deleted Codes

? 78270 Vitamin B-12 absorption study (eg, Schilling test); without intrinsic factor

? 78271 Vitamin B-12 absorption study (eg, Schilling test); with intrinsic factor

? 78272 Vitamin B-12 absorption studies combined, with and without intrinsic factor

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11/27/2018

Contrast Microbubble Ultrasound

? New

? 76978 Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion

? +76979 Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)

? Deleted

? C9744 Ultrasound, abdominal, with contrast

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MR Elastography

? New

? 76391 Magnetic resonance (eg, vibration) elastography

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11/27/2018

US Elastography

? New

? 76981 Ultrasound, elastography; parenchyma (eg, organ)

? 76982 Ultrasound, elastography; first target lesion ? +76983 Ultrasound, elastography; each additional

target lesion (List separately in addition to code for primary procedure)

? Deleted

? +0346T Ultrasound, elastography (List separately in addition to code for primary procedure)

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US Elastography

? Report 76981 only once per session for evaluation of the same parenchymal organ

? For evaluation of a parenchymal organ and lesion(s) in the same parenchymal organ at the same session, report only 76981

? Do not report +76983 more than two times per organ

? To report shear wave liver elastography without imaging use 91200

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11/27/2018

MRI Breast

? Deleted

? 77058 Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral

? 77059 Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral

? +0159T Computer-aided detection, including computer algorithm analysis of MRI image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation, breast MRI (List separately in addition to primary procedure)

? C8904 Magnetic resonance imaging without contrast, breast; unilateral

? C8907 Magnetic resonance imaging without contrast, breast bilateral

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MRI Breast

? New

? 77046 Magnetic resonance imaging, breast, without contrast material; unilateral

? 77047 Magnetic resonance imaging, breast, without contrast material; bilateral

? 77048 Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral

? 77049 Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral RadRx

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11/27/2018

CAD Breast MRI HCPCS Code (OPPS)

? C8937 Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/ characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)

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Parenthetical Notes

? Revised based on other code changes

? Revised notes 76000 ? Revised notes 76376/76377 ? Revised notes 76942 ? Revised notes 76998 ? Revised notes +77001 ? Revised notes +77002 ? Revised notes 77012 ? Revised notes 77021

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-FY Modifier

? Reported on claims including codes that describe X- rays taken using computed radiography.

? 7% reduction on payments for services between CY 2018 and CY 2022

? 10 % reduction in subsequent years

? Required for the technical component, global billing. ? When payment for X-ray or computed radiography

services are packaged into those for another item or service under the OPPS, there is no payment attributable to X-ray or computed radiography, and therefore, there would be no corresponding payment reduction to either service.

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Radiology Assistants

? Revised supervision requirements ? All diagnostic imaging tests may be furnished under the

direct supervision of a physician when performed by an RA in accordance with state law and state scope of practice rules.

? Diagnostic tests performed by a registered radiologist assistant (RRA) or a radiology practitioner assistant (RPA) require only a direct level of supervision, when permitted by state law and state scope of practice regulations.

? For diagnostic imaging tests requiring general level of supervision, this modification will not change the level of physician supervision to direct supervision. RadRx

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