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?
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LABORATORY

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

Question:
Can we use hydration codes to report drug infusion?
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RADIOLOGY

Question:
What are the anticipated changes to percutaneous core needle lung biopsy?
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RESPIRATORY

Question:
Do you have any advice for billing oximetry trend studies?
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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?
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[Lori]

For the Week of June 12, 2023​

CARDIOLOGY​

Can we report 93463 for pharmacologic agent administration in conjunction with coronary interventional procedures?
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LABORATORY​

When can 81418 be used? What is the minimum amount of genes that must be sequenced?
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RADIOLOGY​

What type of bill must be assigned for screening mammograms?
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RESPIRATORY​

Can we use fractional time amounts when reporting additional time with code 94781?
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GENERAL​

Can a subcutaneous injection of insulin administered to a patient be billed?
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[Lori]

For the Week of June 19, 2023​

CARDIOLOGY​

How would we code for the following scenario? An interventional cardiologist performs a PTCA in the LAD followed by drug-eluting stent placement in the same vessel, subsequently the physician next performs a PTCA in the RCA.
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LABORATORY​

Is 80050 covered by Medicare?
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RADIOLOGY​

We have been following the instruction that 75774 only applies to subselective ARTERIAL studies; however, CPT® Assistant September 2022 states “If venography is performed in a main vessel and then a selective venogram is performed, report code 75774 in addition to the venography code for the initial vessel. Can you please clarify any current instructions?
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RESPIRATORY​

Can we obtain VO2 by calculation?
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GENERAL​

We use 96360 and 96361 for hydration fluids administered in radiology. These codes often edit against the CT procedure code. What modifier would you recommend? Regarding the question of an appropriate modifier for billing of hydration therapy with a CT scan, we should clarify that we are billing for a hospital radiology dept.
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[Lori]

For the Week of June 26, 2023​

CARDIOLOGY​

Am I understanding correctly that the Category III 0715T can only be used when a bare metal stent is placed?
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LABORATORY​

Can you tell us more about the billing details for 85060 and whether we should include this code this in our hospital chargemaster?
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RADIOLOGY​

Regarding pulmonary angiography coding, when a catheter is placed in the main pulmonary artery and an angiogram was performed with findings, we know this is considered nonselective. However, when a catheter was selected into RT and LT pulmonary arteries but no angiogram was performed before a thrombectomy was performed, what is the coding here? Should we code 75746, 36014RT, and 36014LT, or do we change 75746 to 75743 since they went selectively into RT and LT pulmonary arteries? Please clarify.
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RESPIRATORY​

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 a cytologic examination was peformed, is 31622 correct?
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GENERAL​

Can we include the elapsing time between establishing vascular access and initiating the infusion, or the preparation time and post-monitoring time when reporting intravenous chemotherapy infusions?
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[Lori]

For the Week of July 3, 2023​

CARDIOLOGY​

How should DES stents with lithotripsy be reported for facility coding since the C-codes are not listed as a primary intervention?
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LABORATORY​

What is the correct code if a physician has ordered a CBC exclusively with no mention of a differential?
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RADIOLOGY​

Should screening mammography be delayed after a recent COVID-19 vaccination?
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RESPIRATORY​

How is code 94762 reimbursed?
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GENERAL​

Can we use 96372 for allergen immunotherapy?
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[Lori]

For the Week of July 10, 2023​

CARDIOLOGY​

Is catheter placement bundled in the new PA revasc. codes?
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LABORATORY​

Are there still coding and compliance risks posed by COVID-19 testing and protocol? Is there a potential for audits in the future?
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RADIOLOGY​

What code would use for a catheter placed into the internal jugular with contrast injection and imaging?
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RESPIRATORY​

What are the codes for home sleep testing and what are the payment rates?
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GENERAL​

Can we report 90471 and 90473 together?
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[Lori]

For the Week of July 17, 2023​

CARDIOLOGY​

A patient arrives for a redo PVI due to evidence of continuing atrial fibrillation. The EP study performed demonstrates continued PVI block. 3D mapping and programmed stimulation with Isuprel elucidate that the patient is having episodes of mitral annulus atrial flutter that is ablated. How should this situation be coded?
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LABORATORY​

When reporting separate results for different species or strains of an infectious agent with the same CPT code, do we report each additional billed unit?
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RADIOLOGY​

Just for clarification on the Knee MR Arthrogram; When ordered and service performed, billing is as follows: Fluoro guidance used for the injection you would not report 73580. Submission is for the fluoro, injection, and MR?
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RESPIRATORY​

What does Medicare cover for an HST procedure?
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GENERAL​

Does CMS require that the JW modifier be reported when billing for packaged drugs?
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[Lori]

For the Week of July 24, 2023​

CARDIOLOGY​

How should the use of DFR be coded in the facility setting?
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LABORATORY​

Can we report 87088 multiple times with 87086?
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RADIOLOGY​

Would the sacroiliac joint be a medium or large joint?
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RESPIRATORY​

How is extended monitoring defined for codes 95812 and 95813?
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GENERAL​

When is code 96367 assigned?
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[Lori]

For the Week of August 7, 2023​

CARDIOLOGY​

If a patient is brought to the cardiac cath lab and only bypass grafts were visualized (for example, SVG [saphenous vein graft] to the right coronary artery [RCA], and SVG to the circumflex) with no native coronary arteries being injected or imaged, what is the appropriate CPT® procedure to code/charge?
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LABORATORY​

If you do the AHG technique, do you report all three of the codes, or just
86922?
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RADIOLOGY​

Would you use 64450 for a femoral cutaneous nerve block?
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RESPIRATORY​

Do 94667 and 94668 apply to the demonstration of the patient’s utilization of a flutter valve device?
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GENERAL​

How would we bill the concurrent IV administration of one chemotherapy drug and one non-chemotherapy when the drugs are given with separate bags at the same site?
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[Lori]

For the Week of August 14, 2023​

CARDIOLOGY​

How do you code for an abdominal aortogram/lower extremity angiography during a cardiac catheterization?
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LABORATORY​

What revenue code or codes do you use when coding for blood transfusions? Does it matter which blood product is used?
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RADIOLOGY​

If the documentation doesn’t state the origin for 20551, should we code 20550?
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RESPIRATORY​

What is the difference between codes 31640, 31641, and 31643?
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GENERAL​

For billing chemotherapy infusions, what determines the selection of the primary CPT® code?
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[Lori]

For the Week of August 21, 2023​

CARDIOLOGY​

A patient presents for percutaneous transfemoral TAVR. Upon completion of TAVR, a dissection is noted in the common femoral access vessel. This is treated with angioplasty and stent. Is it appropriate to code CPT 37221 for the femoral artery angioplasty and stenting in addition to the TAVR, CPT 33361®?
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LABORATORY​

Can we report 88112 with 88108?
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RADIOLOGY​

If the documentation states a core biopsy of the disc space, would we still use 62267?
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RESPIRATORY​

Are there any important compliance points to know for physician orders and respiratory rehabilitation services?
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GENERAL​

What are some examples of documentation indications for medically necessary fluid replacement for hydration therapy?
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