AMA Clinical Examples in Radiology - 2013 Issue 2 (Spring)
Q&As
Questions and Answers Question: Answer: Does a bone tomogram on a PET scanner utilizing sodium fluoride F-18 qualify as a tomogram study as described by code 78320 ? Note: Currently, Medicare reimbursement of sodium fluoride-18 (NaF) PET bone imaging is based on participation in CMS' "coverage with evidence development" (CED) through the National Oncologic PET Registry (NOPR) program. The choices of CPT codes to report in this example for the NOPR program are codes 78811 - 78816 plus all of the appropriate modifiers. Code selection is dependent on the area imaged and whether CT for anatomical localization was performed. For...
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Article Overview
This article collects short coding questions and answers from radiology practice. It focuses on how to think about reporting several imaging and interventional scenarios, including PET bone imaging, thrombolysis-related service timing, and hip joint injection workflows. It also references Medicare coverage context, NCCI edits, and when certain modifiers may be considered in the examples discussed. The content is useful for radiology coders, billers, and compliance staff who need a quick overview of the types of guidance covered before consulting the full article.
Why This Topic Matters
Radiology coding often depends on procedure context, payer policy, and how bundled services are reported. This article highlights those issues across imaging and intervention examples that commonly create claim-edit and documentation questions.
Article Sections
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PET bone imaging question
Discusses a radiology coding question involving PET bone imaging and related Medicare coverage context. The section addresses the general reporting considerations for this imaging scenario.
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Thrombolysis timing and extremity procedures
Covers a question about infusion timing for thrombolysis when services are performed on the same date. The section also references claim-edit concerns, specialty-society advocacy, and related reporting context.
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Hip joint injections and related imaging
Addresses a question about reporting separate procedures through the same access point for a hip joint study. The section also discusses the associated imaging component and MRI context.
What You Will Learn
- The general coding topics covered in radiology Q&A format
- How the article frames Medicare and registry-based coverage context
- How thrombolysis timing questions are presented in relation to same-day services
- How joint injection scenarios are discussed alongside related imaging services
- Which broad types of NCCI and modifier issues are referenced in the examples
Who Should Read This
- Radiology coders
- Medical billers
- Coding auditors
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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