Resource Compliance Questions of the Week

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A weekly email update that answers difficult trending billing and coding questions in Radiology, Cardiology, Pharmacy, Laboratory and other specialties.

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SEPTEMBER 14, 2020


CARDIOLOGY

Question:
May we report code 0482T (absolute quantification) along with the new cardiac positron emission tomography (PET) codes in 2020?
READ THE ANSWER

LABORATORY

Question:
Can we perform repeat organ and disease-oriented panel procedures on a single day of service?
READ THE ANSWER

PHARMACY

Question:
Can we use hydration codes to report drug infusion?
READ THE ANSWER

RADIOLOGY

Question:
What are the anticipated changes to percutaneous core needle lung biopsy?
READ THE ANSWER

RESPIRATORY

Question:
Do you have any advice for billing oximetry trend studies?
READ THE ANSWER

GENERAL

Question:
A progress note from our nurse practitioner (NP) indicated that she was called by nursing to see a patient due to “unequal pupils.” The NP ordered a CT/CTA to rule out associated dissection or blood clot post angiogram earlier today. Would it be correct to assign a diagnosis code for unequal pupils as primary?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF JANUARY 31, 2022​

CARDIOLOGY​

​

Question:
How do the new 2022 congenital catheterization code directives define normal native connections?
READ THE ANSWER

LABORATORY​

​

Question:
Can you provide details about when to report new codes 81523 and 81560?
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PHARMACY​

​

Question:
Can you tell us if codes 96365 and 96368 are appropriate for the following scenario? The patient is seen in the outpatient clinic for drug infusion. Drug A is administered from 6:00 am to 7:30 am. Drug B is administered through the same intravenous line from 7:00 am to 4:00 pm.
READ THE ANSWER

RADIOLOGY​

​

Question:
When should new 2022 codes 50436 and 50437 not be reported?
READ THE ANSWER

RESPIRATORY​

​

Question:
Do any special billing requirements exist related to new 2022 codes 94625 and 94626?
READ THE ANSWER

GENERAL​

​

Question:
The ED physician ordered NS 1000 ml @ 250 ml/hr and CT abdomen with contrast. Are we able to code 96360 for the IV hydration?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF FEBRUARY 7, 2022​

CARDIOLOGY​

​

Question:
As a follow-up to last week’s question, how do the new 2022 congenital catheterization code directives define abnormal native connections?
READ THE ANSWER

LABORATORY​

​

Question:
Why were codes 81228 and 81229 revised in 2022?
READ THE ANSWER

PHARMACY​

​

Question:
When is the JW modifier reported?
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RADIOLOGY​

​

Question:
When it comes to the new 2022 radiology directives, how is a foreign body defined?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can you tell me more about how “direct supervision” was defined prior to the public health emergency for pulmonary rehabilitation and tobacco counseling services?
READ THE ANSWER

GENERAL​

​

Question:
What documentation is required if our non-hospital imaging center needs to do an exam in addition to that which was ordered by the patient’s treating physician?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF FEBRUARY 14, 2022​

CARDIOLOGY​

​

Question:
What is the intent of code 93463?
READ THE ANSWER

LABORATORY​

​

Question:
What services do you expect will rebound more quickly as the pandemic eases? How can labs prepare for increased service volumes?
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PHARMACY​

​

Question:
Can give more details about the status indicator of radiopharmaceuticals grouped under N?
READ THE ANSWER

RADIOLOGY​

​

Question:
Do you have any tips for reporting the new 2022 prostate laser ablation code 0655T?
READ THE ANSWER

RESPIRATORY​

​

Question:
Is CMS suspending most Medicare Fee-For-Service (FFS) medical reviews during the Public Health Emergency (PHE) for the COVID-19 pandemic?
READ THE ANSWER

GENERAL​

​

Question:
Regarding endovascular repair of an abdominal aortic aneurysm (formerly EVAR), what is meant by ‘rupture’?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF FEBRUARY 21, 2022​

CARDIOLOGY​

​

Question:
What code would we report for a thermodilution indicator dilution study for cardiac output measurement during cardiac catheterization for a congenital heart defect?
READ THE ANSWER

LABORATORY​

​

Question:
Can you give me some tips for reflex urinalysis when it comes to compliance?
READ THE ANSWER

PHARMACY​

​

Question:
For intravenous drug infusion, is it necessary to identify whether the time of observation services is billable in addition to the time for highly complex drug administration?
READ THE ANSWER

RADIOLOGY​

​

Question:
What is the purpose of code 99072? We’ve heard it is for reporting additional pandemic supplies, is this true?
READ THE ANSWER

RESPIRATORY​

​

Question:
Is it ok to use Bilevel devices as ventilators or should we use CPAP devices if a ventilator is not available?
READ THE ANSWER

GENERAL​

​

Question:
If an IV antibiotic was administered but the MAR only contains the time the infusion started, can we charge for an IV push?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF FEBRUARY 28, 2022​

CARDIOLOGY​

​

Question:
What code would I report for transapical access of the left atrium during cardiac catheterization for a congenital heart defect? Is there a new 2022 code for this?
READ THE ANSWER

LABORATORY​

​

Question:
Why were new 2022 codes 0246U and 0282U established?
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PHARMACY​

​

Question:
Can you tell us if codes 96365 and 96368 are appropriate for the following scenario? The patient is seen in the outpatient clinic for drug infusion. Drug A is administered from 6:00 am to 7:30 am. Drug B is administered through the same intravenous line from 7:00 am to 4:00 pm.
READ THE ANSWER

RADIOLOGY​

​

Question:
How was 75573 revised?
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RESPIRATORY​

​

Question:
Can we use the time in and out of the department to calculate billable units of service for respiratory rehabilitation service codes?
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GENERAL​

​

Question:
Are inpatient respiratory therapy services included in room and board?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MARCH 7, 2022​

CARDIOLOGY​

​

Question:
When should new code 93462 not be reported?
READ THE ANSWER

LABORATORY​

​

Question:
When should we report new 2022 code 86015?
READ THE ANSWER

PHARMACY​

​

Question:
What does therapeutic drug administration include?
READ THE ANSWER

RADIOLOGY​

​

Question:
What are some guidelines for reporting the new lumbar spine allogeneic injection T Codes?
READ THE ANSWER

RESPIRATORY​

​

Question:
How is COVID-19 still impacting respiratory therapy services? What adjustments and adaptations should professionals still be making to endure the crisis?
READ THE ANSWER

GENERAL​

​

Question:
Do carotid stent placement codes include angioplasty?
READ THE ANSWER

 

[Lori]

To provide you with the most actionable compliance and regulatory questions, we are retiring the pharmacy compliance question of the week to focus on answering more commonly asked questions that safeguard accurate coding and save reimbursement. The pharmacy archive will still be available and is accessible here. Compliance Question of the Week will continue to help you overcome compliance challenges, reduce operational waste, and optimize healthcare.

FOR THE WEEK OF MARCH 14, 2022​

CARDIOLOGY​

​

Question:
The patient presents for a diagnostic left heart catheterization (LHC), left ventriculogram and selective coronary angiography. The physician determines that hemodynamic assessment
should be performed before and after exercise to assist in the clinical diagnosis. The patient is given a pair of 2.5-pound dumbbell weights then asked to exercise by extending
the arms and bringing the arms with the weights to their chest. The patient exercises for three to five minutes. Does this type of exercise meet the criteria for billing code 93464?
READ THE ANSWER

LABORATORY​

​

Question:
What code was created for ANCA testing in 2022?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can imaging of the arch (36221) be reported with the codes for carotid or vertebral angiography?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can new codes 98981 and 98980 be reported together?
READ THE ANSWER

GENERAL​

​

Question:
What’s the difference between extra-cranial carotid circulation and intra-cranial carotid circulation?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MARCH 21, 2022​

CARDIOLOGY​

​

Question:
What codes can we use 93566 with?
READ THE ANSWER

LABORATORY​

​

Question:
What is the minimum per-mile travel allowance for 2022 for specimen collection?
READ THE ANSWER

RADIOLOGY​

​

Question:
How would you code when selective renal angiography is performed on the main renal artery (first-order vessel) in the right kidney, then a selective angiogram is performed on a second-order vessel in the left kidney?
READ THE ANSWER

RESPIRATORY​

​

Question:
What code would I report for a pediatric pneumogram?
READ THE ANSWER

GENERAL​

​

Question:
Is there a hierarchy if several procedures are performed intracranially? How do I determine which code is correct?
READ THE ANSWER

 

[Lori]

To provide you with the most actionable compliance and regulatory questions, we are retiring the pharmacy compliance question of the week to focus on answering more commonly asked questions that safeguard accurate coding and save reimbursement. The pharmacy archive will still be available and is accessible here. Compliance Question of the Week will continue to help you overcome compliance challenges, reduce operational waste, and optimize healthcare.

FOR THE WEEK OF APRIL 4, 2022​

CARDIOLOGY​

​

Question:
Can injection procedure codes 93563-93568 be reported in conjunction with one another?
READ THE ANSWER

LABORATORY​

​

Question:
As a follow-up question to last week’s topic, can you provide any examples of per flat-rate trip billing?
READ THE ANSWER

RADIOLOGY​

​

Question:
We received an order from a referring physician that requested an ultrasound (US) thyroid for nodule assessment and a US soft tissue for a submental mass palpable on the exam. The facility coder believes that the facility should get two charges. The interpretation covers both areas in one report. It is my understanding that US head and neck (CPT® 76536) would cover both of these assessments. Am I correct? The evaluation is performed for two separate reasons, but the imaging is of the neck.
READ THE ANSWER

RESPIRATORY​

​

Question:
What are the codes for extended EEG monitoring and how do they differ from normal EEG monitoring?
READ THE ANSWER

GENERAL​

​

Question:
For cervical carotid stenting, is there a code for ‘each additional vessel’?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF APRIL 11, 2022​

CARDIOLOGY​

​

Question:
How would you code this scenario? An interventional cardiologist performs a PTCA in the LAD artery. The physician also performed angioplasty in the diagonal side branch of the patient’s LAD during the same session.
READ THE ANSWER

LABORATORY​

​

Question:
Do the NCCI updates that clarify CPT® utilization guidelines for multi-gene panel coding still remain in effect for 2022? If so, what do they specify?
READ THE ANSWER

RADIOLOGY​

​

Question:
What is the difference between codes 55700 and 55706? They both describe needle biopsy of the prostate, how do you determine which to use?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can you bill CNP per hour with negative-pressure ventilation in an acute situation?
READ THE ANSWER

GENERAL​

​

Question:
What is meant by a stent for biliary procedures?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF APRIL 18, 2022​

CARDIOLOGY​

​

Question:
What code do I report for transcatheter ventricular restoration device implantation ?
READ THE ANSWER

LABORATORY​

​

Question:
Can you tell me what are the common billing mistakes involving specimen collection?
READ THE ANSWER

RADIOLOGY​

​

Question:
How is a grayscale ultrasound of a transplanted kidney, transplanted ureter, and native bladder reported?
READ THE ANSWER

RESPIRATORY​

​

Question:
When do we report 94799?
READ THE ANSWER

GENERAL​

​

Question:
What is splenoportography?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF APRIL 25, 2022​

CARDIOLOGY​

​

Question:
How would you code the following scenario? An interventional cardiologist performs a percutaneous left heart catheterization, then selective injections of the left ventricle and coronary arteries for diagnostic purposes followed by mechanical thrombectomy of the LAD artery with subsequent drug eluting stent placement in the LAD.
READ THE ANSWER

LABORATORY​

​

Question:
What must documentation show if appending a modifier to bill multiple CPT codes that represent analysis performed on a single specimen?
READ THE ANSWER

RADIOLOGY​

​

Question:
How do you determine whether a bone biopsy would be considered superficial (20220) or deep (20225)?
READ THE ANSWER

RESPIRATORY​

​

Question:
How do we code for the instruction of patients on the use of the metered dose inhaler nd/or the hand held nebulizer? We know that service is described in 94664, but we don’t know what additional code if any should be reported or if we should use only 94664. Would we use 94799 for the education portion?
READ THE ANSWER

GENERAL​

​

Question:
What is an internal-external biliary drainage catheter?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MAY 2, 2022​

CARDIOLOGY​

​

Question:
What is included in 0644T?
READ THE ANSWER

LABORATORY​

​

Question:
What is the update for local clinical laboratory fees in 2022? What is the national minimum payment amount?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can you clarify whether a screening mammogram or a diagnostic mammogram should be performed on an asymptomatic patient with augmented breasts (e.g., breast implants)?
READ THE ANSWER

RESPIRATORY​

​

Question:
Are there any limitations to pulmonary function studies that we should be aware of?
READ THE ANSWER

GENERAL​

​

Question:
What is portography?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MAY 9, 2022​

CARDIOLOGY​

​

Question:
Can you report 0644T when cardiopulmonary bypass is performed in conjunction with percutaneous intracardiac mass removal?
READ THE ANSWER

LABORATORY​

​

Question:
What is the consumer price index for 2022?
READ THE ANSWER

RADIOLOGY​

​

Question:
What are the codes for atherectomy in the iliac arteries?
READ THE ANSWER

RESPIRATORY​

​

Question:
What does APC status indicator J1 identify?
READ THE ANSWER

GENERAL​

​

Question:
What is meant by selective pelvic angiography?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MAY 16, 2022​

CARDIOLOGY​

​

Question:
Our cardiologist first performed a diagnostic left heart catheterization, followed by selective injections into the left ventricle and coronary arteries. Next, separate and discrete PCI was performed on the following vessels: Right coronary artery DES, Diagonal PTCA, Branch 1 of diagonal PTCA, and Branch 2 of diagonal PTCA. Do you know how we would code for this?
READ THE ANSWER

LABORATORY​

​

Question:
Can we report 88112 with 88108 or bill the concentration separately using 88108?
READ THE ANSWER

RADIOLOGY​

​

Question:
What decision was made in regard to the final coverage for monoclonal antibodies and amyloid PET?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we report 31622 if the operative report states that the tracheobronchial tree was evaluated with a bronchoscope and that sterile saline washings were recovered and sent for culture and cytologic examination is performed?
READ THE ANSWER

GENERAL​

​

Question:
Is there a code for the removal of a gastrostomy or other colonic tube?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MAY 23, 2022​

CARDIOLOGY​

​

Question:
What code would I report for percutaneous transluminal angioplasty with recurrent coarctation of the aorta?
READ THE ANSWER

LABORATORY​

​

Question:
How will the PREVENT pandemics act impact labs?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can you tell me more about the early release Category III codes that may impact radiology?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we report 95806 for home sleep tests?
READ THE ANSWER

GENERAL​

​

Question:
Can you explain to me what the NCCI is?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF MAY 30, 2022​

CARDIOLOGY​

​

Question:
Can you tell me more about what is included in 0643T?
READ THE ANSWER

LABORATORY​

​

Question:
What are PLA Codes?
READ THE ANSWER

RADIOLOGY​

​

Question:
Are there any more changes to E/M coming in 2023?
READ THE ANSWER

RESPIRATORY​

​

Question:
What are the documentation requirements for respiratory rehabilitation services?
READ THE ANSWER

GENERAL​

​

Question:
What is an external biliary drainage catheter?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF JUNE 6, 2022​

CARDIOLOGY​

​

Question:
Our interventional cardiologist performed a PTCA in the LAD, an atherectomy in the RCA, and placed a drug-eluting stent in the left circumflex artery (LC). How would we code for this?
READ THE ANSWER

LABORATORY​

​

Question:
Can we use flow cytometry codes to report absolute cell counts (not requiring interpretation)?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can imaging guidance for central venous access catheter or device placement be separately reported?
READ THE ANSWER

RESPIRATORY​

​

Question:
What happened with codes 93720–93722 for plethysmography? We keep getting denials when we try to use these codes.
READ THE ANSWER

GENERAL​

​

Question:
If a patient had a G-tube, D-or J-tube, or G-J tube previously and needs a new one placed through a new access, would this be coded as a replacement?
What is an external biliary drainage catheter?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF JUNE 13, 2022​

CARDIOLOGY​

​

Question:
Our interventional cardiologist deployed a bare-metal stent within the LAD and performs angioplasty within both the LC coronary artery and the RCA. How would we code this?
READ THE ANSWER

LABORATORY​

​

Question:
When do we use add-on code 88141?
READ THE ANSWER

RADIOLOGY​

​

Question:
If we perform a bone density on the hips and forearm can we bill both CPT codes 77080 and 77081 together?
READ THE ANSWER

RESPIRATORY​

​

Question:
Do you have any tips for billing 95803?
READ THE ANSWER

GENERAL​

​

Question:
What is the difference between an arteriovenous (AV) fistula and an AV graft?
READ THE ANSWER

 

[Lori]

FOR THE WEEK OF JUNE 20, 2022​

CARDIOLOGY​

​

Question:
What do left heart congenital catheterization codes (93595, 93596, 93597) include?
READ THE ANSWER

LABORATORY​

​

Question:
If you do the AHG technique, do you report all three of the codes, or just 86922?
READ THE ANSWER

RADIOLOGY​

​

Question:
When coding and reporting for services that would fall under 78012 can we unbundle the uptake and imaging procedure into separate component codes?
READ THE ANSWER

RESPIRATORY​

​

Question:
Does Medicare cover codes 94014 and 94015? We seem to be running into problems when reporting these.
READ THE ANSWER

GENERAL​

​

Question:
Can you explain how the term “fusion” relates to positron emission tomography/computed tomography services?
READ THE ANSWER