AMA Clinical Examples in Radiology - 2011 Issue 1 (Winter)
Questions and Answers
Questions and Answers Question: Answer: Are there any Medicare edits that limit the number and type of CT abdomen and CT pelvis studies that may be reported by a provider for the same patient on the same day? Yes. Medicare currently has Medically Unlikely Edits (MUEs) in place for the standalone computed tomography (CT) abdomen codes ( 74150 , 74160 , 74170 ) and the stand-alone CT pelvis codes ( 72192 , 72193 , 72194 ) that limit the reporting of these codes to one CT abdomen code and one CT pelvis code for a patient when performed on the same day. In...
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Article Overview
This question-and-answer article reviews several practical radiology coding topics discussed in Medicare, CMS, AMA, and ACR guidance. It covers imaging edits, bundled versus separately reported services, diagnostic test ordering parameters, and reporting considerations for certain ultrasound and vascular procedures. The content is aimed at radiology coders, billing staff, and other professionals who need to understand how current guidance affects reporting and reimbursement.
Why This Topic Matters
The article helps readers assess whether common radiology services are subject to reporting edits, bundling, or ordering clarifications that can affect claims processing and compliance.
Article Sections
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Medicare edits for CT abdomen and pelvis studies
Discusses Medicare payment edits and claim-reporting limits for related abdominal and pelvic CT studies, including national coding edit concepts and same-day reporting considerations.
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CPT 2011 cholecystostomy imaging bundling update
Addresses a CPT coding clarification involving a percutaneous gallbladder drainage procedure and associated imaging supervision and interpretation guidance, along with a referenced correction notice.
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Ordering diagnostic tests and number of X-ray views
Summarizes CMS and ACR guidance on who may determine diagnostic test parameters when an order does not specify them, with references to federal regulation and Medicare manual material.
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Diagnostic angiogram and lower extremity revascularization reporting
Reviews reporting issues when diagnostic imaging accompanies lower extremity vascular intervention, including catheterization and related supervision-and-interpretation considerations.
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CPT ultrasound extremity guidance
Explains a CPT ultrasound topic involving supervision, scanning responsibilities, and a prior code background referenced in CPT changes materials.
What You Will Learn
- How Medicare edits can affect reporting of related CT studies on the same day
- How a CPT imaging update affects separate reporting of a bundled service
- How diagnostic test orders may be interpreted when specific imaging parameters are omitted
- How reporting considerations differ when diagnostic imaging accompanies vascular intervention
- How CPT ultrasound guidance addresses supervision and patient scanning responsibilities
Who Should Read This
- Radiology coders
- Medical billers
- Physician practice staff
- Hospital revenue cycle teams
- Imaging reimbursement specialists
Codes Discussed
Code Ranges Discussed
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