by Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
February 10th, 2020
A 2020 Radiology Coding Change You Need To Ex”SPECT”
The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is time to get acquainted with the newest changes to the Radiology codes now.
In tomographic (SPECT) imaging, special gamma cameras are used in combination with radiopharmaceuticals (radioactive agents) to produce true 3D images of a structure or organ system being analyzed. A radiopharmaceutical agent is administered to the patient, often intravenously, prior to the procedure and once it has reached the targeted structure or organ system, imaging can begin. A special gamma camera scans the body, picking up the radioactive energy produced from the radiopharmaceutical and converts it into 3D images for review and interpretation. Because the radiopharmaceutical agent will absorb differently into damaged, diseased, or abnormal tissues than it will into healthy tissues, the images will specifically highlight details of these areas within the organ system or structure.
With the 2020 radiology code updates, code 78803 was revised to take the place of the tomographic (SPECT) imaging which was reported with codes 78205, 78206, 78320, 78607, 78647, and 78710 for the liver, heart, brain, joints, and other areas. Code 78803 should be reported when the imaging is done on a single area on a single day. When imaging two (2) areas (or more) on a single day or a single area over two or more days, see code 78831.
Correct and detailed documentation is important to support the claims so be sure the name of the radiopharmaceutical, dosing, and route of administration are included in the report. Also, regardless of where the service takes place, there must be a written report that describes the study performed and an interpretation of the findings.
If your organization performs these services frequently, be sure to review the updated guidelines and associated NCCI edits to ensure proper reporting. Checking NCCI edits is easy with the CCI Validation tool on Find-A-Code. Simply enter the codes from your claim, click the "validate" button and any bundling issues will appear with information identifying those that may qualify for unbundling under appropriate circumstances. What are the appropriate circumstances for unbundling? Your subscription allows you to search the NCCI Policy Manual by year and chapter to identify the rules and guidelines describing when it is appropriate to override an NCCI code pair.
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