AMA Clinical Examples in Radiology - 2019 Issue 2 (Spring)
Questions and Answers
QUESTIONS AND ANSWERS Question Answer Ultrasound study of the back to measure spinal expansion rods is performed. Because the expansion rods are located within the soft tissues of the upper back, should Current Procedural Terminology (CPT ® ) code 76604 -52 or an unlisted procedure code be reported? It is appropriate to report code 76604 -52 , Ultrasound, chest (includes mediastinum), real time with image documentation, with modifier 52, Reduced services, appended as the examination is tailored for evaluation of hardware within the posterior chest soft tissues without imaging of additional chest structures. * CPT code 76604 is frequently used...
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Article Overview
This premium Q&A article from Clinical Examples in Radiology reviews several radiology coding scenarios and the related CPT reporting considerations. It is intended for coders, radiologists, and billing professionals who need to understand the scope of guidance on imaging studies, second interpretations, post-processing, and embolization services. The article also notes documentation and medical-necessity themes that affect how these services are reported.
Why This Topic Matters
Radiology coding questions often turn on subtle differences in the service performed, the imaging context, and whether additional work was done separately. This article helps readers identify which broad CPT reporting topics are addressed before consulting the full guidance.
Article Sections
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Ultrasound of the back and reduced services
Discusses a soft-tissue ultrasound scenario involving hardware in the upper back and the related CPT reporting context. It also references documentation themes for ultrasound examinations.
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Computer-aided detection with prostate MRI
Covers a prostate MRI scenario involving computer-aided detection and the broader issue of reporting unlisted MRI procedures. It also mentions payer processing considerations for unlisted services.
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KUB views versus images
Explains an abdominal radiography scenario involving kidneys, ureters, and bladder imaging and the distinction between views and images. It focuses on how that distinction affects CPT reporting for abdominal radiographs.
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Second interpretation and 3D rendering
Addresses outside-study second interpretations for CT or MRI and the related topic of 3D post-processing. The section also discusses documentation and supervision themes tied to reporting advanced imaging post-processing.
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Prostate artery embolization for symptomatic BPH
Reviews a prostate artery embolization scenario in the setting of symptomatic benign prostatic hyperplasia and urinary tract symptoms. It includes broader embolization coding context and related radiological supervision and interpretation concepts.
What You Will Learn
- How the article frames several common radiology coding scenarios.
- Which CPT reporting topics are addressed for ultrasound, MRI, radiography, 3D rendering, and embolization.
- What general documentation and medical-necessity issues are highlighted in the Q&A.
- How the article situates selected services within broader CPT coding categories.
Who Should Read This
- Radiology coders
- Medical billers
- Radiologists
- Coding auditors
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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