© 2010 Delmar, Cengage Learning Chapter 16 CPT Radiology.

© 2010 Delmar, Cengage Learning

Chapter 16

CPT Radiology


Radiology Subsections

• The following subsections are further divided into anatomic categories:– Diagnostic radiology imaging– Diagnostic ultrasound– Radiation oncology– Nuclear medicine


Diagnostic Imaging Subsection

• Includes:– Noninvasive diagnostic and therapeutic procedures

– Invasive diagnostic and therapeutic procedures

– Computerized tomography (CT)– Magnetic resonance imaging (MRI)


Planes of View

• Coronal (frontal)• Midsagittal• Sagittal• Transverse (horizontal, axial)

(continued)


Planes of ViewPlanes that separate body structures (midsagittal, sagittal, coronal, and transverse)


Radiographic Projections

• Anteroposterior projection• Lateral projection (side view)

• Oblique projection• Posteroanterior (PA)


Radiographic Projections


Radiology Procedures

• Angiography• Aortography• Arthrography• Computed axial tomography (CT, CAT)

• Computed tomography angiography (CTA)

(continued)



• Nuclear imaging• Positron emission tomography (PET)

• Single photon emission computerized tomography (SPECT)

• Ultrasound (ultrasonography)• Venography• X-ray



• Cystography• Fluoroscopy• MRI


Contrast Medium Injection Device


Lateral Chest X-RayBones of the spine are white; soft tissues are shades of gray


Abdominal CT ScanLiver is predominant in upper-left; stomach is visible in upper-right


Fluoroscopy UnitDynamic radiographic examination that allows for visualization of flow of barium through gastrointestinal tract, injection of a contrast agent into the heart, etc.

Courtesy of GE Healthcare.


Computed Tomography Sections


3D Computed Tomography Angiography Reconstructions

(continued)

Carotid arteries


3D Computed Tomography Angiography Reconstructions

Coronary arteries


MRIIncludes stationary magnet, radio frequency coil, and gradient coils


MRI of the BrainCourtesy of GE Healthcare


Key Terms

• Roentgen (R, r)• Radiation absorbed dose (rad)• Gray (gy)• Roentgen-equivalent-man (rem)



• Three components:– Technical component– Professional component– Global service

• Modifiers:– -26 (professional component)– -TC (technical component)


Coding Tips

• Modifier -50 (bilateral procedure) is not added to radiology procedures that are performed bilaterally because code descriptions often specify “bilateral.”

• Modifier -51 (multiple procedures) is not usually added to radiology codes.

• HCPCS level II anatomical modifiers -Lt and -Rt are added when appropriate.


“Complete”

• Number of views required for study of a designated body part

• Do not confuse use in the code description with use in a parenthetical note below a code


E/M Services Provided by Radiologist

• No code reported when radiologist provides E/M services as part of radiographic procedure


Radiology Section Guidelines

• Provide instruction about:– Subject listings– Separate procedures– Subsection information– Unlisted service or procedure– Special report– Supervision and interpretation– Administration of contrast material(s)

– Written report(s)


Radiology Subsections

• The following Radiology subsections contain notes unique to the subsection:– Diagnostic ultrasound– Radiation oncology– Nuclear medicine


Separate Procedures

• Some procedures are considered an integral component of a total service or procedure and are identified by the descriptor “separate procedure.”


Special Report

• When a service is new, unusual, or rarely provided, it requires a special report to validate the medical necessity and appropriateness of the service (e.g., complexity of symptoms).


Component Coding

• Allows for reporting a radiology procedure code and a surgical procedure code to completely describe the service provided


Radiology Coding

• To accurately code diagnostic radiology procedures, identify:– Anatomic site– Type of procedure– Number of views– Laterality of procedure – Use of contrast media


Vascular Procedures

• Selective vascular catheterization

• Nonselective vascular catheterization


Coding Tip

• Report a separate code when a diagnostic angiography or venography is performed during a separate session (from the interventional procedure).


Ultrasound Display Modes

• A-mode (amplitude modulation)• B-scan (brightness mode, gray-scale ultrasound)

• M-mode (motion mode)• Real-time scan


Ultrasound Guidance Procedures

• Report either a diagnostic ultrasound or guidance ultrasound code, but not both for the same patient during the same encounter.


Radiation Oncology

• Radiation oncology codes include professional services and technical procedures that are organized according to types of treatment provided:– Consultation– Clinical treatment planning– Radiation treatment delivery– Neutron beam treatment delivery


Clinical Treatment Planning

• External sources• Internal sources• Systemic radiation therapy• Stereotactic radiosurgery (SRS)

• Stereotactic body radiation therapy (SBRT)


Coding Tip

• Clinical treatment planning is reimbursed:– Once per course of radiation therapy– Only when performed directly by radiation oncologist


Therapeutic Radiology Treatment

• Types of planning:– Simple– Intermediate– Complex


Radiation Treatment Delivery

• Includes ongoing patient evaluation (codes not reported separately)

• Codes are reported for administration of radiation therapy per treatment


Nuclear Medicine

• Subsection contains two headings:– Therapeutic– Diagnostic

© 2010 Delmar, Cengage Learning Chapter 16 CPT Radiology.

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transverse slide

cpt radiology slide

axial continued slide

shades of gray slide

upperright slide

man rem slide