AMA Clinical Examples in Radiology - 2017 Issue 4 (Fall)
Percutaneous Cryoablation of a Pulmonary Tumor
CLINICAL EXAMPLE 1 Percutaneous Cryoablation of a Pulmonary Tumor INDICATION A 72-year-old male with a history of left nephrectomy for renal cell carcinoma 1 year ago had a right lower lobe 2.2-cm lung nodule on computed tomography (CT). Biopsy revealed metastatic renal cell cancer. The patient was referred by the oncology service for focal cryoablation therapy. The patient was seen in the interventional clinic prior to the procedure and chose to proceed with treatment. TECHNIQUE 99152 99153 X 3 Informed consent was obtained on the morning of the procedure. The patient was placed supine on the CT...
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Article Overview
This radiology coding article uses a clinical example to explain how a percutaneous cryoablation case for a pulmonary tumor is coded across different CPT timeframes, along with related ICD-10-CM diagnosis coding. It is intended for coders, billing staff, and clinicians who work with interventional radiology, oncology-related procedures, and evolving CPT guidance.
Why This Topic Matters
The article helps readers understand how a single pulmonary cryoablation case was represented in CPT before and after a coding change, and how associated diagnosis codes are linked to a metastatic lung lesion and prior kidney malignancy history. It is useful for keeping coding workflows aligned with current procedural terminology and diagnosis reporting expectations.
Article Sections
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Clinical Example 1
Introduces the patient scenario and the clinical context for the interventional radiology procedure.
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Indication
Summarizes the clinical background that led to the procedure and the reason for referral.
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Technique
Describes the imaging-guided procedural approach, sedation, and intra-procedural monitoring.
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Findings
Provides the post-procedure assessment of the treatment result.
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How to Code
Presents the coding assignments discussed for the procedure and related reporting elements.
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Discussion
Explains the broader coding context, including reporting changes over time, related guidance, and diagnosis coding considerations.
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For Dates of Service Starting January 1, 2018, the Procedure Described Above Should Be Reported as Follows:
Shows the later coding framework associated with the same clinical scenario and notes the updated procedural reporting context.
What You Will Learn
- How a pulmonary tumor cryoablation case is organized for coding review
- How moderate sedation is addressed in the example
- How procedure coding changed across different reporting periods
- How associated diagnosis coding is presented for metastatic lung disease and prior malignancy history
- How the article frames the relationship between evolving CPT guidance and interventional radiology services
Who Should Read This
- Medical coders
- Radiology coding specialists
- Billing and reimbursement staff
- Interventional radiology clinicians
- Oncology coding teams
Codes Discussed
Modifiers Discussed
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