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Radiology Coding Alert - December 2011 Edition

Alert Details

Effective for dates of service January 1, 2012 and forward, the CPT Editorial Panel has approved the following changes to Radiology CPT codes.

Spine Radiography

In an effort to eliminate potential ambiguity CPT has updated some of the verbiage related to lumbar spine x-rays. This verbiage is changing to focus on the number of views, rather than specific types of views. 

  • 72100 – Radiological examination, spine, lumbosacral; 2 or 3 views (no change)
    • 2012 Work RVU = 0.22 (same as 2011)
  • 72110 – Radiological examination, spine, lumbosacral; minimum of 4 views (no change)
    • 2012 Work RVU = 0.31 (same as 2011)
  • 72114 – Radiological examination, spine, lumbosacral; complete, including bending views, minimum of 6 views
    • 2012 Work RVU = 0.32 (decreased from 0.36 in 2011)
  • 72120 – Radiological examination, spine, lumbosacral; bending views only, 2 or 3 views
    • 2012 Work RVU = 0.22 (same as 2011)

CTA Abdomen and Pelvis

CT Angiography imaging of the Abdomen and Pelvis is frequently performed together during the same patient encounter. A new “combined” CPT code has been created to reflect current practice. 

  • 74174 – Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including non-contrast images, if performed, and image post processing
    • 2012 Work RVU = 2.20 

The individual component CPT codes for CTA Abdomen and CTA Pelvis are still valid to report when individual services are performed. The Work RVUs for both codes will remain the same as in 2011. 

  • CTA Abdomen only (74175) = 1.90
  • CTA Pelvis only (75635) = 1.81  

Bone/Joint Studies

The CPT Editorial Panel has deleted the following CPT codes, as they are considered to be obsolete services. 

  • 77079 – Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)
  • 77083 – Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites 

Hepatobiliary Scintigraphy

There have been a variety of additions and deletions to the CPT codes in this section. The new codes more accurately reflect the studies being commonly performed today.  

Deleted Codes

  • 78220 – Liver function study with hepatobiliary agents, with serial images
  • 78223 – Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitative measurement of gallbladder function 

New Codes

  • 78226 – Hepatobiliary system imaging, including gallbladder when present
    • This code can be used if gallbladder is absent
    • 2012 Work RVU = 0.74
  • 78227 – Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed
    • 2012 Work RVU = 0.90 

Pulmonary Scintigraphy

The section of CPT codes that represent pulmonary perfusion and/or ventilation imaging has been revised. CPT codes 78584 - 78596 have been deleted and new “combined” codes have been created to illustrate services typically performed together.  

New Codes

  • 78579 – Pulmonary ventilation imaging (eg, aerosol or gas)
    • 2012 Work RVU = 0.49
  • 78582 – Pulmonary ventilation (eg, aerosol or gas) AND perfusion imaging
    • 2012 Work RVU = 1.07
  • 78597 – Quantitative differential pulmonary perfusion, including imaging when performed
    • 2012 Work RVU = 0.75
  • 78598 – Quantitative differential pulmonary perfusion AND ventilation (eg, aerosol or gas), including imaging when performed
    • 2012 Work RVU = 0.85 

Revised Code (verbiage only)

  • 78580 – Pulmonary perfusion imaging (eg, particulate)
    • 2012 Work RVU = 0.74 (same as 2011) 

Gastric Emptying Study

This CPT code was evaluated for an increase in Work RVU. The AMA identified this study as having increased utilization. Work standardization has changed over time and interpretation is more complex now.

  • 78264 – Gastric emptying study
    • 2011 Work RVU = 0.77
    • AMA RVS Update Committee (RUC) requested increase to 0.95 Work RVU
    • 2012 Work RVU = 0.80

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