Technological advancements have flooded the field of diagnostic and interventional radiology in recent years and new codes have been created to accommodate these changes. Reliable medical coding companies keep track of these changes as they are well aware that using the new diagnostic radiology codes is crucial to help radiologists maximize revenue opportunities and minimize audit risks. Moreover, in the radiology environment, errors in coding can lead to high claim denial rates and impact profitability in the long run.
Here are the diagnostic radiology CPT code additions, deletions and modifications for 2017.
Mammography
One important change this year is mammography bundling. Three CPT codes have been deleted and replaced by a new set of three CPT codes – 77065, 77066, and 77067 – that bundle digital mammography, film screen mammography, and computer-aided detection (CAD) mammography. However, the Centers for Medicare and Medicaid Services (CMS) is delaying the adoption of these new bundled CPT codes for a year, citing issues relating to claims processing systems. CMS is retaining the currently used G-codes at least till 2018.
- G0202 (CPT 77067) Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed
- G0204 (CPT 77066) Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral
- G0206 (CPT 77065) Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral
Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)
AAA is a weakening in the wall of the infrarenal aorta and ultrasound screening is performed for early detection of swelling or rupture. Bursting is usually acute, but can prove fatal. In many cases, AAAs are undiagnosed as patients may not experience symptoms until rupture develops.
In 2017, there is a new CPT code – 76706 – for abdominal aortic aneurysm (AAA) screening. This service was previously reported with HCPCS code G0389. Report: CPT 76706, Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)
Note: For this new code, reimbursement for the professional component is 5% lower, while the global reimbursement is 19% lower.
Fluoroscopic Guidance
Fluoroscopy is an imaging technique that uses X-rays to produce real-time moving images of the body’s internal structure. Applications include arthography, discography and image-guided biopsy, barium enema, barium swallow and myelogram. There are revisions to two CPT codes for fluoroscopic guidance: 77002 and 77003. These were previously standalone codes that were not subject to the global period concept. Starting January 1, 2017, these codes need to be reported in addition to coding for a primary procedure and included in the global period for the primary codes. As the work RVU values for these codes were revised upward for 2017, they will be reimbursed at a higher rate.
- 77002, Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device) – to be listed separately in addition to code for primary procedure
- 77003, Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) – to be listed separately in addition to code for primary procedure
Note: As guidance is included in all arthrography radiological supervision and interpretation codes, 77002 should not be added to those procedures.
An increasing number of radiologists are adopting new technologies and integrating a more patient-centered focus into their workflow. With changing codes and payment reform, updating radiology medical billing and coding knowledge is necessary to maximize reimbursement and minimize denials. In this scenario, reliable medical billing services can go a long way to optimize revenue cycle management.
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