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?
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?
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[Lori]

For the Week of November 28, 2022​

CARDIOLOGY​

For Medicare hospital billing, if a planned PTCA is attempted but the balloon cannot be advanced across the lesion, can we bill for the attempted angioplasty?
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LABORATORY​

Can we code diagnoses with terms documented such as “probable,” and “suspected?”
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RADIOLOGY​

How do you code for a 3, 6, 9, and 12 o’clock breast mass/lesion since there are no “other specified site” or “unspecified quadrant” codes? ICD-10-CM code N63 (Unspecified breast lump) requires specification of the quadrant of the lump site. The radiology report states, “12 o’clock right breast mass.”
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RESPIRATORY​

When do we report codes 99453 and 99454?
READ THE ANSWER

GENERAL​

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?

 

[Lori]

For the Week of December 5, 2022​

CARDIOLOGY​

Is code 92973 the appropriate code for aspiration of a thrombus within a coronary vessel?
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LABORATORY​

Is there coverage for initial screening for hepatitis C virus (HCV) for adults at high risk for HCV infection?
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RADIOLOGY​

Can 76942 be billed more than once per session during trigger-point injections (e.g., 20553) if multiple areas are injected, or should it be one 76942 per session?
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RESPIRATORY​

Do you have any general tips regarding correct documentation for pulmonary function studies?
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GENERAL​

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

 

[Lori]

For the Week of December 26, 2022​

CARDIOLOGY​

Do you have any tips for using the JW modifier when reporting low osmolar contrast media/non-ionic contrast?
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LABORATORY​

Are there any updates regarding the Clinical Laboratory Fee Schedule for 2023?
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RADIOLOGY​

Can we report 78445 in addition to any other nuclear medicine procedure?
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RESPIRATORY​

Can we report 94200 when using the forced expiratory volume (FEV1) from the spirogram to calculate an estimated MVV?
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GENERAL​

Can we report medically necessary hydration in addition to blood transfusion?
Read the answer

 

[Lori]

For the Week of January 9, 2023​

CARDIOLOGY​

What does new code 93569 detail and include?
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LABORATORY​

What code would be best to report when performing both concentration and enrichment of cytology specimens beyond a concentration technique alone?
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RADIOLOGY​

What is the intent of the new 2023 code 0743T??
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RESPIRATORY​

When performing an inhalation treatment for acute airway obstruction, will CMS pay for 94640 and 94644 if billed on the same
date of service for the same patient?
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GENERAL​

When it comes to reporting for intraperitoneal chemotherapy, how do we code for IV push of an anti-emetic agent when it is added to the treatment plan?

 

[Lori]

For the Week of January 16, 2023​

CARDIOLOGY​

Is 93575 a new code for 2023? If so, when would we report it?
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LABORATORY​

Are there any changes to the NCCI policy manual for the molecular pathology section?
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RADIOLOGY​

What does new 2023 code 0724T detail?
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RESPIRATORY​

Do you have any tips for billing for an oximetry trend study?
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GENERAL​

For billing chemotherapy infusions, what determines the selection of the primary CPT code?

 

[Lori]

For the Week of January 23, 2023​

CARDIOLOGY​

What are the coding guidelines for new code 0715T?
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LABORATORY​

How does the Omnibus Appropriations Bill impact labs for this year?
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RADIOLOGY​

Are there any 2023 NCCI changes for radiation oncology?
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RESPIRATORY​

What is the APC rate for code 94762 in 2023?
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GENERAL​

Do we need to report start and stop times in the medical record when reporting 0540T?

 

[Lori]

For the Week of January 30, 2023​

CARDIOLOGY​

We’ve heard there is a new modifier effective this year, is this true? If so what does it report?
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LABORATORY​

What is the status of the Saving Access to Laboratory Services Act (SALSA) for 2023? Was this included in the omnibus package passed last year?
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RADIOLOGY​

How do you determine the appropriate code to report an MRI of the foot? Should it be reported as an MRI of the lower extremity joint or as an MRI of the lower extremity non-joint?
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RESPIRATORY​

Does additional preparation and documentation of 60 minutes impact the assignment for EEG code 95816?
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GENERAL​

How do we report CAR-T drug administration in the hospital outpatient setting?

 

[Lori]

For the Week of February 6, 2023​

CARDIOLOGY​

What do codes 33900, 33901, 33902, 33903, and 33904 include?
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LABORATORY​

What codes replace deleted PLA code 0097U?
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RADIOLOGY​

When reporting a lymphangiogram, what code is billed for direct access and injection into the thoracic duct for thoracic ductogram?
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RESPIRATORY​

Does additional preparation and documentation of 60 minutes impact the assignment for EEG code 95816?
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GENERAL​

Can you tell me more about the guidelines for how CART-T infusion is administered and performed?

 

[Lori]

For the Week of February 13, 2023​

CARDIOLOGY​

What do codes 33900, 33901, 33902, 33903, and 33904 include?
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LABORATORY​

When would we use code 87913?
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RADIOLOGY​

When reporting lymphangiogram, can we code both an extremity and abdomen/pelvis RS&I?
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RESPIRATORY​

When is lung function evaluation performed for pulmonary function testing?
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GENERAL​

Can we charge separately for supportive medicated injections/infusions given at the time of the cell therapy?

 

[Lori]

For the Week of February 20, 2023​

CARDIOLOGY​

Can we report 92997 and 92998 separately?
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LABORATORY​

When is 81418 reported?
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RADIOLOGY​

What do codes 36836 and 36837 describe and what is the difference between the codes?
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RESPIRATORY​

Do you have any billing tips for reporting 94010?
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GENERAL​

For CAR-T cell administration, can we report lymphodepleting (LD) chemotherapy separately if it is administered prior to the day that cell therapy is administered?

 

[Lori]

For the Week of February 27, 2023​

CARDIOLOGY​

What are the differences between codes 75625 and 75630 for an abdominal aortogram?
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LABORATORY​

What are the current options for the analysis of somatic cancers? Are there codes for RNA-only analysis?
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RADIOLOGY​

What needs to be imaged and documented in order to report code 76641 for a complete breast ultrasound?
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RESPIRATORY​

When is continuous overnight oximetry considered investigational and not medically necessary?
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GENERAL​

Can we separately report codes 96360 and 96361 for CAR-T?

 

[Lori]

For the Week of March 6, 2023​

CARDIOLOGY​

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?
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LABORATORY​

What is the intent of new code 84433?
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RADIOLOGY​

Are there any NCCI instructions for radiopharmaceutical code A9512?
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RESPIRATORY​

What should the charges account for in code 94002?
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GENERAL​

Is care on the same date of service that is not directly related to the service of administration of the CAR-T cells separately reportable?

 

[Lori]

For the Week of March 13, 2023​

CARDIOLOGY​

What are the definitions for the abdominal aorta and the thoracic aorta?
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LABORATORY​

What changes occurred to the code description for 0016M?
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RADIOLOGY​

Would code 76881 or 76882 be the correct code assignment if an ultrasound is performed to evaluate multiple joints for the presence of arthritis? Would it be appropriate to assign a code per joint evaluation?
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RESPIRATORY​

What are the newest category III codes for reporting bronchoscopy with the insertion of an esophageal protection device and the inclusion of fluoroscopic guidance?
READ THE ANSWER

GENERAL​

How is tocilizumab for COVID-19 reported? Can we report it in an outpatient setting?

 

[Lori]

For the Week of March 27, 2023​

CARDIOLOGY​

For IVUS coding, what code do we report if a single pathology such as a bridging lesion crosses from one vessel to another?
READ THE ANSWER

LABORATORY​

What is the update to the local clinical laboratory fee for 2023?
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RADIOLOGY​

Can contrast-enhanced ultrasound codes (76978–76979) be reported in addition to grayscale ultrasound codes if performed in the same session?
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RESPIRATORY​

Is there a CPT code to report when a respiratory therapist provides instruction on how to use incentive spirometry in a physician’s office?
READ THE ANSWER

GENERAL​

When are the code series 0537T-0540T reported?

 

[Lori]

For the Week of April 3, 2023​

CARDIOLOGY​

When do we report 0505T?
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LABORATORY​

What is the CPI for 2023?
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RADIOLOGY​

If duplex exams of both an upper and a lower extremity are ordered and performed at the same encounter, would it be appropriate to report CPT code 93971 twice even though that code has an MUE of 1?
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RESPIRATORY​

Does 94640 cover intrapulmonary percussive ventilation (IPV) therapy?
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GENERAL​

If hydration is ordered for 4 hours before and 4 hours after a CT scan with contrast is performed, can we charge for the hydration hours?

 

[Lori]

For the Week of April 17, 2023​

CARDIOLOGY​

What findings should I look for in the report to support a diagnostic abdominal aortogram (75625)?
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LABORATORY​

Can you explain more of the rationale behind the term “drug of abuse?”
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RADIOLOGY​

Please confirm if these percutaneous codes apply to the The WavelinQ™ EndoAVF System indicated for the creation of an arteriovenous fistula (AVF)
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RESPIRATORY​

Are there any nuances to consider for 2023 respiratory therapy rehabilitation (RTR)?
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GENERAL​

Do you have any tips for reporting 36593?
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[Lori]

For the Week of April 24, 2023​

CARDIOLOGY​

Do codes 37252 and 37253 include supervision?
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LABORATORY​

What is the intention behind modifier 91?
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RADIOLOGY​

For NM exams that are chosen based on single-day imaging vs two or more days— how do you consider the following? Imaging at four hours on Monday, imaging at 24 hours on Tuesday. Are you counting as a single day for a 24-hour period or as 2 days based on calendar days? Is there an official reference that may be sourced?
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RESPIRATORY​

For polysomnography, what must the face-to-face clinical evaluation include?
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GENERAL​

When should we report 90460 and 90461?
READ THE ANSWER

 

[Lori]

For the Week of May 22, 2023​

CARDIOLOGY​

Why was category III code 0742T established for cardiology?
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LABORATORY​

When is modifier 33 reported?
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RADIOLOGY​

What code do we report for the placement of a percutaneous nephrostomy tube into the kidney for drainage?
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RESPIRATORY​

What are the billing requirements for 94625 and 94626?
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GENERAL​

Do we assign G0498 for administering a non-chemotherapy drug via prolonged infusion requiring the use of a portable or implantable pump?
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[Lori]

For the Week of May 29, 2023​

CARDIOLOGY​

Would we report a modifier with code 93926 in a physician-owned setting?
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LABORATORY​

Can we report 80299 only once?
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RADIOLOGY​

What does 76881 require for examination?
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RESPIRATORY​

What components are included in 94060?
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GENERAL​

Can we bill 99195 separately for the nursing visit?
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[Lori]

For the Week of June 5, 2023​

CARDIOLOGY​

Would we report a modifier for code 93926 in a hospital-based setting?
READ THE ANSWER

LABORATORY​

What is the difference in coding for 81025 and 84703?
READ THE ANSWER

RADIOLOGY​

For the pulmonary angio codes, if the RHC is done in the cath lab but the pulmonary angiogram is done in IR which codes would be used where?
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RESPIRATORY​

For code 95807, what does “attended” mean?
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GENERAL​

If the start and stop times are not documented on an infusion, can I bill an IV push?
READ THE ANSWER